Saito Takashi, Senda Kazuyoshi, Takakura Shunji, Fujihara Naoko, Kudo Toyoichiro, Linuma Yoshitsugu, Fujita Naohisa, Komori Toshiaki, Baba Naoshi, Horii Toshinobu, Matsuoka Kimiko, Tanimoto Mitsune, Ichiyama Satoshi
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Clin Chem Lab Med. 2003 Mar;41(3):293-7. doi: 10.1515/CCLM.2003.046.
The anaerobic blood culture (AN) bottle is routinely used in Japan with little discussion as to its justification or validity. We retrospectively studied the AN bottle yield of obligate anaerobes and the characteristics of, and potential risk factors in, patients with anaerobic bacteremia during a 2-year period (1999-2000) at four university hospitals and one community hospital. Thirty-four of 18,310 aerobic and anaerobic blood culture sets from 6,215 patients taken at the university hospitals, and 35 of 2,464 samples taken from 838 patients at the community hospital, yielded obligate anaerobes. Bacteroides species and Clostridium species accounted for 60% of the isolates. Fifty-seven patients from 69 blood culture sets containing anaerobes had clinically significant anaerobic bacteremia. Among these 57 patients, 24 (49%) were oncology patients, 40 (70%) had an obvious source of anaerobic infection, 15 (26%) had recent surgery and/or were in an immunosuppressed state. We concluded that the recovery rate of obligate anaerobes isolated from AN bottles was low, and the patients with anaerobic bacteremia had limited number of underlying diseases or potential risk factors for anaerobic infections. Therefore, anaerobic blood cultures may be selectively used according to the potential risk for anaerobic infections.
厌氧血培养（AN）瓶在日本被常规使用，却很少有人讨论其合理性或有效性。我们对四家大学医院和一家社区医院在两年期间（1999 - 2000年）从厌氧血培养瓶中分离出专性厌氧菌的情况、厌氧菌血症患者的特征及潜在危险因素进行了回顾性研究。在大学医院采集的6215例患者的18310套需氧和厌氧血培养标本中，有34套培养出专性厌氧菌；在社区医院采集的838例患者的2464份标本中，有35份培养出专性厌氧菌。分离出的菌株中拟杆菌属和梭菌属占60%。69套含有厌氧菌的血培养标本对应的57例患者发生了具有临床意义的厌氧菌血症。在这57例患者中，24例（49%）为肿瘤患者，40例（70%）有明显的厌氧感染源，15例（26%）近期接受过手术和/或处于免疫抑制状态。我们得出结论，从厌氧血培养瓶中分离出专性厌氧菌的回收率较低，厌氧菌血症患者的基础疾病或厌氧感染的潜在危险因素数量有限。因此，可根据厌氧感染的潜在风险选择性地进行厌氧血培养。
