快速药敏试验检测血流感染病原菌的准确性及适用性研究  

Accuracy and applicability study of rapid antimicrobial susceptibility testing(RAST)in detecting pathogenic bacteria of bloodstream infection

作　　者：陆艳 任传利[1] 王福安[2] 李贵玲[1] LU Yan;REN Chuanli;WAN Fuan;LI Guiling(Department of Laboratory Medicine,Northern Jiangsu People's Hospital,Yangzhou,Jiangsu 225001,China;Interventional Department,Northern Jiangsu People's Hospital,Yangzhou,Jiangsu 225001,China)

机构地区：[1]江苏省苏北人民医院医学检验科,江苏扬州225001 [2]江苏省苏北人民医院介入科,江苏扬州225001

出　　处：《中国实验诊断学》2025年第3期281-287,共7页Chinese Journal of Laboratory Diagnosis

基　　金：国家自然科学基金(82172345);江苏省自然科学基金(BK20221281);扬州市基础研究计划(联合专项)(2024-4-05)。

摘　　要：目的验证快速药敏试验(Rapid Antimicrobial Susceptibility Testing,RAST)技术在检测血培养阳性样本时,对常见病原菌及常用药物在不同时间段读取结果的可靠性。方法依据欧洲抗菌药物敏感性试验委员会发布的RAST指南,采用RAST技术检测血流感染中常见的革兰阴性细菌和革兰阳性细菌对11种常用抗菌药在4个不同时间段(4、6、8 h和16~20 h)的药敏测试结果,并将其与常规药敏试验方法结果进行比较,验证其一致性。结果对104例血培养阳性标本进行了RAST研究分析,在4个不同的时间段(4、6、8 h和16~20 h)读取了药敏测试结果,结果显示分类一致性分别为86.28%、87.99%、90.78%和93.18%,极重大错误的比例分别为0.26%、0.25%、0.24%和0.24%,重大错误的比例分别为4.75%、4.66%、4.13%和3.76%,微小错误的比例分别为8.71%、7.11%、4.85%和2.82%。结论在8 h和16~20 h对RAST读取结果,其总体结果具有较高的可靠性,能够有效地用于快速评估血流感染病原菌的药物敏感性。在4 h和6 h读取结果,RAST对于生长较快的病原菌的符合率表现良好,然而对于生长缓慢的病原菌,可阅读数的比例相对比其他时间段低,其符合率也稍显不足。Objective To verify the reliability of the rapid antimicrobial susceptibility testing(RAST)technology in detecting positive blood culture samples,regarding the results of common pathogenic bacteria and commonly used drugs read at different time intervals.Methods According to the RAST guidelines issued by the European Committee on An-timicrobial Susceptibility Testing,the RAST technology was used to detect the antimicrobial susceptibility test results of common Gram-negative and Gram-positive bacteria in bloodstream infections against 11 commonly used antibiotics at four different time intervals(4 hours,6 hours,8 hours,and 16~20 hours).These results were then compared with those obtained by the conventional antimicrobial susceptibility testing method to verify their consistency.Results RAST research analysis was conducted on 104 positive blood culture specimens.The antimicrobial susceptibility test re-sults were read at four different time intervals(4 hours,6 hours,8 hours,and 16~20 hours).The results showed that the categorical agreement rates were 86.28%,87.99%,90.78%,and 93.18%respectively.The proportions of very major errors were 0.26%,0.25%,0.24%,and 0.24%respectively.The proportions of major errors were 4.75%,4.66%,4.13%,and 3.76%respectively.The proportions of minor errors were 8.71%,7.11%,4.85%,and 2.82%re-spectively.Conclusion The research results show that when the RAST results are read at 8 hours and 16~20 hours,the overall results are highly reliable and can be effectively used to rapidly assess the drug susceptibility of pathogenic bacteria in blood infections.When the results are read at 4 hours and 6 hours,RAST exhibits a good coincidence rate for fast-growing bacteria of the order Enterobacterales.However,for slow-growing pathogenic bacteria,the proportion of readable numbers is relatively lower compared to other time periods,the coincidence rate is somewhat insufficient.

关 键 词：血培养 血流感染 快速药敏试验 药敏试验 

分 类 号：R44[医药卫生—诊断学]