阳性血培养标本菌种快速鉴定及药敏试验方法研究  

Rapid bacterial identification and antimicrobial susceptibility testing assay in positive blood cultures

作　　者：范芳华[1] 王选 张亚培[1] 肖震[1] 周瑛 董世雷[1] FAN Fanghua;WANG Xuan;ZHANG Yapei;XIAO Zhen;ZHOU Ying;DONG Shilei(Department of Microbiology Laboratory,Zhejiang Hospital,Hangzhou,Zhejiang 310013,China;Zhejiang Hospital,Hangzhou,Zhejiang 310013,China)

机构地区：[1]浙江医院医学检验科微生物室,浙江杭州310013 [2]浙江医院,浙江杭州310013

出　　处：《预防医学》2023年第8期732-736,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省基础公益研究计划项目(LGC19H190002)。

摘　　要：目的建立能快速实现阳性血培养标本菌种鉴定和药敏试验的方法,为及时诊断和治疗血流感染患者提供参考。方法收集2022年2—5月浙江医院住院患者血培养标本1154份,通过改良分离胶分离法富集纯化菌体,采用VITEK MS质谱仪和VITEK2 Compact全自动微生物系统进行菌种鉴定和药敏试验。以传统VITEK2 Compact检测法(传统法)为标准,检验菌种鉴定和药敏试验结果的准确率。结果1154份血培养标本经传统法鉴定阳性174份,阴性980份。对174份阳性标本采用本方法进行菌种鉴定,165份与传统法鉴定结果一致,鉴定准确率为94.83%,其中革兰阴性菌准确率为99.21%,革兰阳性菌准确率为82.22%。对本方法与传统法鉴定结果相符的158株菌进行药敏试验,准确率为90.17%,其中革兰阴性菌准确率为90.27%,革兰阳性菌准确率为89.74%。传统法菌种鉴定和药敏报告总用时≥30 h,本方法可缩短至9~18 h。结论本方法由于减少了细菌转种培养时间,可快速实现血培养标本的菌种鉴定和药敏检测,且准确率满足临床需求,有助于血流感染患者的快速诊断和治疗。Objective To establish a rapid bacterial identification and antimicrobial susceptibility testing assay in positive blood cultures,so as to provide insights into timely diagnosis and treatment of bloodstream infections.Methods A total of 1154 blood culture samples were collected from inpatients in Zhejiang Hospital from February to May,2022.The bacterial isolates were enriched and purified using improved separation gel method,and bacterial identification and antimicrobial susceptibility tests were performed using VITEK2 mass spectrometry system and VITEK2 Compact automated microbiology system.The accuracy of the new assay for bacterial identification and antimicrobial susceptibility tests was evaluated with the conventional VITEK 2 compact system as the standard.Results Of 1154 blood culture specimens,the conventional VITEK 2 compact system detected 174 positives and 980 negatives.The new assay and the conventional VITEK 2 compact system identified consistent bacterial isolates in 165 out of 174 positive blood culture samples,and the accuracy of bacterial identification was 94.83%for the new assay,with a 99.21%accuracy for identifying Gram-negative bacteria and 82.22%for Gram-positive bacteria.Antimicrobial susceptibility tests were performed in 158 bacterial isolates,and the new assay presented a 90.17%accuracy,with a 90.27%accuracy for Gram-negative bacteria and 89.74%for Gram-positive bacteria.The conventional VITEK 2 compact system required 30 hours and longer to complete bacterial identification and antimicrobial susceptibility tests,and the new assay required 9 to 18 hours.Conclusions The new rapid bacterial identification and antimicrobial susceptibility testing assay shortens the time of bacterial culture,achieves rapid bacterial identification and antimicrobial susceptibility testing in blood culture specimens and has a high accuracy that meets clinical needs,which facilitates rapid diagnosis and treatment of bloodstream infections.

关 键 词：血培养 细菌鉴定 药敏试验 VITEK MS质谱仪 VITEK2 Compact全自动微生物系统 

分 类 号：R372[医药卫生—病原生物学]