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[血培养延迟对自动血培养系统阳性检测的影响]

[Effect of delay of blood cultures on positive detection by automated blood culture system].

作者信息

Kobayashi Intetsu, Yamamoto Mariko, Hasegawa Miyuki, Sato Yumie, Uchino Utsuki, Kaneko Akihiro

机构信息

Mitsubishi Kagaru Bio-Clinical Laboratories, Inc, Tokyo, Japan.

出版信息

Kansenshogaku Zasshi. 2004 Nov;78(11):959-66. doi: 10.11150/kansenshogakuzasshi1970.78.959.

Abstract

The effect of entry delayed blood culture bottles until the start of incubation for mechanical detection of organism were compared using 2 major blood culture systems; BACTEC 9240 system and BacT/ALERT 3D system. Total of 13 bacterial strains; 5 gram-positive cocci, 7 gram-negative bacilli and Candida parapsilosis which were isolated mainly from blood cultures were used as the test strains. BACTEC 92F, 93F and BacT/ALERT FA, FN bottles were used as the blood culture bottles. All the bottles inoculated with the test strains were incubated and evaluated immediately after standing at room temperature for 24, 42, 48, 54 or 72 hours, using the respective automated blood culture systems. All the bottles were subcultured. The effect of entry delay the blood culture bottles for the mechanical detection was observed in many gram-negative organisms in BACTEC 9240 system. The blood cultures were evaluated not to be positive in 4 of the 10 samples on delaying for 24 hours or in any of the samples on delaying for 42 hours in the BACTEC 92F bottles inoculated with Escherichia coli. In Serratia marcescens, the blood cultures were evaluated not to be positive in 5 of the 10 samples on delaying for 24 hours or in any of the samples on delaying for 42 hours in the BACTEC 92F bottles. In Klebsiella pneumoniae, the blood cultures were evaluated not to be positive in 9 of the 10 samples on delaying for 42 hours. In Enterococcus faecalis, Pseudomonas aeruginosa and Proteus mirabilis, the blood cultures were evaluated not to be positive in 5-6 of the 10 samples on delaying for 42 hours. On the other hand, the blood cultures were evaluated to be positive in most of the samples of Acinetobacter calcoaceticus (except 3 of the 10 samples which were evaluated not to be positive) on delaying for 42 hours in BacT/ALERT 3 D system. The samples except part of Streptococcus spp. were detected by subculture in both the bottles. These results indicate that the delayed time of blood culture bottles before inoculation with the test bacterial samples affects the positive detection of blood cultures markedly in the blood culture system. Therefore, the immediate incubation was considered to be necessary.

摘要

使用两种主要的血培养系统(BACTEC 9240系统和BacT/ALERT 3D系统)比较了在开始培养前延迟放入血培养瓶对微生物机械检测的影响。总共13株细菌菌株,包括5株革兰氏阳性球菌、7株革兰氏阴性杆菌和主要从血培养中分离出的近平滑念珠菌用作测试菌株。BACTEC 92F、93F瓶以及BacT/ALERT FA、FN瓶用作血培养瓶。所有接种了测试菌株的瓶子在室温下放置24、42、48、54或72小时后,立即使用各自的自动化血培养系统进行培养和评估。所有瓶子均进行了传代培养。在BACTEC 9240系统中,许多革兰氏阴性菌都观察到延迟放入血培养瓶对机械检测的影响。在接种了大肠杆菌的BACTEC 92F瓶中,10个样本中有4个在延迟24小时后血培养评估为阴性,或在延迟42小时后所有样本血培养评估为阴性。在粘质沙雷氏菌中,10个样本中有5个在延迟24小时后血培养评估为阴性,或在延迟42小时后所有样本血培养评估为阴性。在肺炎克雷伯菌中,10个样本中有9个在延迟42小时后血培养评估为阴性。在粪肠球菌、铜绿假单胞菌和奇异变形杆菌中,10个样本中有5 - 6个在延迟42小时后血培养评估为阴性。另一方面,在BacT/ALERT 3D系统中,大部分醋酸钙不动杆菌样本(10个样本中有3个评估为阴性除外)在延迟42小时后血培养评估为阳性。除部分链球菌属外,两个系统的瓶子通过传代培养均检测到了样本。这些结果表明,在接种测试细菌样本前血培养瓶的延迟时间对血培养系统中血培养的阳性检测有显著影响。因此,认为立即培养是必要的。

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