4种血培养瓶4种临床常用抗菌药物吸附能力分析  

Analysis of 4 blood culture bottles'adsorption capacity to 4 commonly used antibiotics

作　　者：杨会林[1] 陈娟[1] 闫津津[1] 欧嘉文[1] 文明明[1] 周丽娜 YANG Huilin;CHEN Juan;YAN Jinjin;OU Jiawen;WEN Mingming;ZHOU Lina(Department of Clinical Laboratory,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China)

机构地区：[1]北京大学深圳医院检验科,广东深圳518036

出　　处：《检验医学》2024年第6期578-582,共5页Laboratory Medicine

摘　　要：目的分析4种血培养瓶对亚胺培南、哌拉西林-他唑巴坦、万古霉素和卡泊芬净4种临床常用抗菌药物的吸附能力,为提高血培养病原体检出率提供参考。方法选择亚胺培南、哌拉西林-他唑巴坦、万古霉素和卡泊芬净敏感标准菌株进行配对,将抗菌药物和配对菌株分别加入4种临床常用的血培养瓶(FA plus、FNplus、Aerobic、Anaerobic)进行培养,根据培养瓶报阳情况和阳性报警时长,评估不同血培养瓶对4种抗菌药物的吸附能力。结果对照瓶(无抗菌药物吸附措施)培养5 d均未报阳。FA plus、FN plus、Aerobic、Anaerobic阳性报警率分别为75.0%(15/20)、100.0%(10/10)、70.0%(14/20)、0.0%(0/10)。亚胺培南/大肠埃希菌组,FN plus均能报阳(5/5),阳性报警时长为(12.4±0.3)h,FA plus、Aerobic和Anaerobic5d均未报阳;哌拉西林-他唑巴坦/铜绿假单胞菌组,FAplus和Aerobic能报阳(5/5),阳性报警时长分别为(16.2±0.3)和(18.1±0.4)h,2种血培养瓶阳性报警时长差异有统计学意义(P<0.05);万古霉素/金黄色葡萄球菌组,FA plus、FN plus和Aerobic能报阳,阳性报警时长分别为(16.7±0.4)、(24.1±0.6)和(31.3±3.9)h,3种血培养瓶阳性报警时长差异有统计学意义(P<0.05),Anaerobic培养5 d未报阳。卡泊芬净/白念珠菌组,FA plus和Aerobic能报阳,阳性报警时长分别为(47.1±3.3)和(42.9±2.0)h,2种血培养瓶阳性报警时长差异有统计学意义(P<0.05)。结论FN plus具有吸附亚胺培南、万古霉素的能力,FA plus和Aerobic具有吸附万古霉素、哌拉西林-他唑巴坦和卡泊芬净的能力;对采集血液样本前使用了抗菌药物的患者,不建议使用无吸附抗菌药物措施的血培养瓶,应根据临床抗菌药物使用习惯选择合适的培养瓶。Objective To analyze the adsorption capacity of 4 kinds of blood culture bottles to imipenem,piperacillin-tazobactam,vancomycin and caspofungin,and to provide a reference for improving the determination rate of pathogens in blood culture.Methods Four antibiotics(imipenem,piperacillin-tazobactam,vancomycin and caspofungin)paired with sensitive and standard isolates were used,and blood culture was performed in 4 types of blood culture bottles(FA plus,FN plus,Aerobic and Anaerobic).The adsorption capacity of different blood culture bottles to 4 antibiotics was evaluated according to the positive situation and positive alarm time of blood culture bottles.Results Control bottles(without antibiotic adsorption measures)showed no positivity after 5 d culture.The positive alarm rates were 75.0%(15/20)on FA plus,100.0%(10/10)on FN plus,70.0%(14/20)on Aerobic and 0.0%(0/10)on Anaerobic.Only FN plus showed positivity in imipenem/Escherichia coli group,and the positive alarm time was(12.4±0.3)h.FA plus,Aerobic and Anaerobic showed no positivity for 5 d.In piperacillintazobactam/Pseudomonas aeruginosa group,FA plus and Aerobic showed positivity(5/5),and the positive alarm times were 16.2±0.3 and(18.1±0.4)h,respectively(P<0.05).FA plus,FN plus and Aerobic reported positivity in vancomycin/Staphylococcus aureus group,and the positive alarm times were 16.7±0.4,24.1±0.6 and(31.3±3.9)h,respectively(P<0.05),and Anaerobic showed no positivity for 5 d.FA plus and Aerobic reported positivity in caspofungin/Candida albicans group,and the positive alarm times were 47.1±3.3 and(42.9±2.0)h(P<0.05).Conclusions FN plus has the capacity to adsorb imipenem and vancomycin,while FA plus and Aerobic have the capacity to adsorb vancomycin,piperacillin-tazobactam and caspofungin.For patients who have used antibiotics before blood sample collection,it is not recommended to use blood culture bottles without antibiotic adsorption measures,and appropriate blood culture bottles should be selected according to clinical antibiotic use habits.

关 键 词：血培养 抗菌药物吸附 病原菌 阳性报警时长 

分 类 号：R446.5[医药卫生—诊断学]