需氧瓶和厌氧瓶对兼性厌氧菌血流感染行血培养的诊断效能比较  

Comparison of the detection ability of aerobic and anaerobic bottles for blood culture of facultative anaerobe bloodstream infections

作　　者：潘书娟[1] 刘国春 何洪 靳悦 王鑫[1] 田恩冰[1] Pan Shujuan;Liu Guochun;He Hong;Jin Yue;Wang Xin;Tian Enbing(Department of Clinical Laboratory,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101121,China)

机构地区：[1]北京中医药大学东直门医院检验科,北京101121

出　　处：《中国医刊》2025年第3期301-304,共4页Chinese Journal of Medicine

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2023-3-30)。

摘　　要：目的比较需氧瓶和厌氧瓶在兼性厌氧菌引起的血流感染诊断中的阳性率、漏诊率和及时性。方法选取2021年1月至2023年12月在北京中医药大学东直门医院进行血培养检出兼性厌氧菌的564例成人血流感染患者为研究对象,均使用需氧瓶和厌氧瓶双瓶培养,记录检测阳性率、漏诊率及阳性报警时间(TTP)。结果使用需氧瓶和厌氧瓶双瓶培养共检出葡萄球菌147例、肠球菌65例、链球菌34例、肺炎克雷伯菌167例、大肠埃希菌151例。需氧瓶培养的葡萄球菌报阳瓶数显著高于厌氧瓶(P<0.05),而需氧瓶和厌氧瓶培养的肠球菌、链球菌、肺炎克雷伯菌和大肠埃希菌报阳瓶数差异无统计学意义(P>0.05)。需氧瓶和厌氧瓶的漏诊率,葡萄球菌分别为13.6%(20/147)、51.0%(75/147),肠球菌分别为12.3%(8/65)、30.8%(20/65),链球菌分别为17.6%(6/34)、17.6%(6/34),肺炎克雷伯菌分别为16.2%(27/167)、28.7%(48/167),大肠埃希菌分别为11.9%(18/151)、21.2%(32/151)。需氧瓶和厌氧瓶培养葡萄球菌、肠球菌及链球菌的TTP差异均无统计学意义(P>0.05),肺炎克雷伯菌的TTP分别为12.6(9.1,21.0)h和10.0(7.6,13.0)h,差异有统计学意义(P<0.05),大肠埃希菌的TTP分别为11.0(8.5,14.9)h和9.2(7.4,11.2)h,差异有统计学意义(P<0.05)。结论需氧瓶和厌氧瓶培养不同兼性厌氧菌的阳性率和漏诊率均有差异,厌氧瓶培养肺炎克雷伯菌及大肠埃希菌的TTP小于需氧瓶,双瓶培养可提高兼性厌氧菌血培养的阳性率和及时性,降低漏诊率。Objective To compare the difference in positive rate,missed diagnosis rate,and timeliness between aerobic and anaerobic bottles in the diagnosis of bloodstream infections caused by facultative anaerobe.Method A total of 564 adult blood culture positive cases at Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2021 to December 2023 were involved.All the cases were cultured in both aerobic and anaerobic bottles.The missed diagnosis rate was calculated by recording the positive rate of different culture bottles.The positive rate,missed diagnosis rate,and the time to positivity(TTP)was recorded.Result Using aerobic and anaerobic bottles for double culture,147 cases of Staphylococcus,65 cases of Enterococcus,34 cases of Streptococcus,167 cases of Klebsiella pneumoniae and 151 cases of Escherichia coli were detected.The number of positive bottles for Staphylococcus was significantly higher in aerobic bottles than in anaerobic bottles(P<0.05).There was no significant difference in the number of positive bottles reported in aerobic and anaerobic bottles for Enterococcus,Streptococcus,Klebsiella pneumoniae,and Escherichia coli(P>0.05).The missed diagnosis rates of using aerobic or anaerobic bottles alone were 13.6%(20/147)or 51.0%(75/147)for Staphylococcus,12.3%(8/65)or 30.8%(20/65)for Enterococcus,17.6%(6/34)or 17.6%(6/34)for Streptococcus,16.2%(27/167)or 28.7%(48/167)for Klebsiella pneumoniae,and 11.9%(18/151)or 21.2%(32/151)for Escherichia coli respectively.Comparing the TTP of double positive bottles,there was no significant difference(P>0.05)between aerobic and anaerobic bottles of Staphylococcus,Enterococcus and Streptococcus.The TTP of aerobic and anaerobic bottles for Klebsiella pneumoniae were 12.6(9.1,21.0)h and 10.0(7.6,13.0)h respectively with statistical significance(P<0.05).The TTP of aerobic and anaerobic bottles for Escherichia coli were 11.0(8.5,14.9)h and 9.2(7.4,11.2)h respectively with significant difference(P<0.05).Conclusion There were differences in the positive rate an

关 键 词：兼性厌氧菌 血流感染 阳性率 漏诊率 及时性 

分 类 号：R446.5[医药卫生—诊断学]