Soloaga R, Carballo P, Marcote V, Merkier K, Salcedo V, Fernandez A, Gutfraind Z, Tokumoto M, Galanternik L, Nagel C, Procopio A
División Laboratorio, Sección Microbiología, Dto de Investigación Clínica, Instituto de Cardiología y Cirugía Cardiovascular, Fundación Favaloro, Avda. Belgrano 1746 Piso 2, 1093 Buenos Aires, Argentina.
Rev Argent Microbiol. 2000 Oct-Dec;32(4):196-8.
Few laboratory microbiological procedures are as important as the isolation of microorganisms from blood. To evaluate the usefulness of the terminal subcultures, 5669 blood cultures giving negative results after 7 days of incubation in the Bact/Alert System (Organon Teknika) were studied. Bottles were distributed as follows: 1562 adult aerobic bottles, 119 adult anaerobic bottles, 3960 pediatric bottles and 28 FAN bottles. From 5669 blood cultures, 10 subcultures that yielded growth had not been detected by the system. These included 5 adult aerobic bottles and 5 pediatric bottles, 7 of these microorganisms were considered contaminants according to clinical data (2 Micrococcus spp, 1 staphylococci coagulase negative, 1 Burkholderia cepacia, 1 Peptoestreptococcus spp, 1 Corynebacterium spp, 1 Scedosporium spp) while the other 3 were considered true bacteremia (1 Pseudomonas aeruginosa, 1 Proteus mirabilis, 1 Streptococcus sanguis), although no one made any change in treatment on the basis of the previous isolation. Based on these results the routinary utilization of terminal subcultures is not advisable and should be used only for special cases or a second system of blood culture should be added according to clinical or epidemiological data.
很少有实验室微生物学程序像从血液中分离微生物那样重要。为了评估终末传代培养的效用,对在Bact/Alert系统(Organon Teknika)中培养7天后结果为阴性的5669份血培养进行了研究。培养瓶的分布如下:1562个成人需氧瓶、119个成人厌氧瓶、3960个儿科瓶和28个FAN瓶。在5669份血培养中,该系统未检测到10份传代培养有细菌生长。其中包括5个成人需氧瓶和5个儿科瓶,根据临床数据,这些微生物中有7种被视为污染物(2种微球菌属、1种凝固酶阴性葡萄球菌、1种洋葱伯克霍尔德菌、1种消化链球菌属、1种棒状杆菌属、1种波氏假霉样真菌),而另外3种被视为真正的菌血症(1种铜绿假单胞菌、1种奇异变形杆菌、1种血链球菌),尽管没有人根据之前的分离结果对治疗做出任何改变。基于这些结果,不建议常规使用终末传代培养,仅在特殊情况下使用,或者应根据临床或流行病学数据添加第二个血培养系统。