临床实验室四种血培养瓶对常见病原菌检出效率及抗生素吸附能力实验比较  

Comparative Evaluation of Detection Performance of Four Blood Culture Systems for Common Pathogens and Antibiotic Absorption Binding Capacity in Clinical Laboratory

作　　者：饶亚华 贾珉[1] 王永涛[1] 胡志敏[1] 高嘉嘉 RAO Yahua;JIA Min;WANG Yongtao;HU Zhimin;GAO Jiajia(Department of Clinical Laboratory,Wuhan NO.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院医学检验科,武汉430022

出　　处：《现代检验医学杂志》2024年第5期199-204,共6页Journal of Modern Laboratory Medicine

基　　金：武汉市卫健委临床医学科研项目(WX17Z01)。

摘　　要：目的 比较生物梅里埃BMX-FA/N Plus,郑州Anto,珠海DIER和重庆Zhongyuan四种血培养瓶在常见病原菌检出和抗生素吸附能力的差异。方法 选取武汉市第一医院临床血流感染常见病原菌标准菌株(金黄色葡萄球菌、肺炎链球菌、粪肠球菌、大肠埃希菌、铜绿假单胞菌、流感嗜血杆菌、嗜麦芽窄食单胞菌、脆弱拟杆菌、光滑念珠菌)。将预制的菌悬液和无菌马血注入四种血培养瓶,分别用于模拟未使用抗生素和应用抗生素治疗后患者的血培养样本,其中模拟抗生素治疗样本中添加亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、左氧氟沙星、万古霉素和米卡芬净六种临床常用抗生素。通过记录比较各培养瓶在有、无抗生素干扰下五天内的报阳情况和检出时间,评估其检验性能。结果 在无抗生素干扰情况下,四种血培养瓶对上述9种病原菌的检出率均为100%。DIER需氧瓶对金黄色葡萄球菌、铜绿假单胞菌、流感嗜血杆菌检出时间早于BMX-FA Plus需氧瓶,差异具有统计学意义(t=2.608,5.547,12.247,均P<0.05);Zhongyuan厌氧瓶对金黄色葡萄球菌、肺炎链球菌、粪肠球菌和流感嗜血杆菌的检出时间快于BMX-FA Plus厌氧瓶,平均缩短1.92~10.80 h,差异具有统计学意义(t=30.187,5.367,33.068,24.855,均P<0.05)。在使用抗生素模拟实验中,BMX-FA Plus培养瓶在除头孢哌酮/舒巴坦外的峰浓度抗生素组病原菌检出率均为100%。Zhongyuan血培养瓶在哌拉西林/他唑巴坦、左氧氟沙星和米卡芬净峰浓度抗生素组病原菌检出率均为100%。峰浓度亚胺培南抗生素组国产瓶仅Anto厌氧瓶检出,阳性检出率(66.7%)低于BMX-FA Plus(100%),且检出时间Anto厌氧瓶更晚,差异具有统计学意义(t=-21.000,P=0.030)。结论 无抗生素干扰时,四种血培养瓶对上述病原菌阳性检出率相同,检出时间上DIER和Zhongyuan总体上较BMX-FA/N Plus更短。在有抗生素干扰时,BMX-FA/N PObjective To evaluate the detection performance of common strains and the antimicrobial binding capacity of four blood culture systems made by BMX-FA Plus,Zhengzhou Anto,Zhuhai DIER and Chongqing Zhongyuan.Methods According to the common pathogens of clinical bloodstream infections in Wuhan No.1 Hospital,ATCC standard isolates of Staphylococcus aureus,Streptococcus pneumoniae,Enterococcus faecalis,Escherichia coli,Pseudomonas aeruginosa,Haemophilus influenzae,Stenotrophomonas Maltophil,Bacteroides tenuis and Candida glabla were chosen to explore.Prefabricated bacterial suspension and sterile horse blood were injected into different brands of blood culture systems to simulate the blood samples of patients with non-antibiotic treatment and antibiotic treatment.Six commonly used clinical antibiotics,Imipenem,Piperacillin/Tazobactam,Cefoperazone/Sulbactam,Levofloxacin,Vancomycin and Micafungine,were added to the blood samples after simulated antibiotic treatment.The performance was evaluated by recording the positive bottles and the detection time of each brand culture systems within five days with and without antibiotic.Results In the absence of antibiotic,four blood culture systems showed 100%recovery on all of the pathogens.Staphylococcus aureus,Pseudomonas aeruginosa and Haemophilus influenzae were recovered earlier in DIER aerobic bottles than BMX-FA Plus aerobic bottles,and the differences were statistically significant(t=2.608,5.547,12.247,all P<0.05).The time to detection of Staphylococcus aureus,Streptococcus pneumoniae,Enterococcus faecalis and Haemophilus influenzae in Zhongyuan anaerobic bottles was significantly faster than that of BMX-FA Plus anaerobic bottles,with an average shortening of 1.92~10.80 h,and the differences were statistically significant(t=30.187,5.367,33.068,24.855,all P<0.05).When antibiotics added,BMX-FA Plus culture bottle showed 100%recovery to all the detecting pathogens with the peak concentration antibiotics except Cefoperazone/Sulbactam,while the recovery in Zhongyuan blood cultu

关 键 词：血培养 病原菌 抗生素吸附 阳性检出率 检出时间 

分 类 号：R446.5[医药卫生—诊断学]