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烧伤患者厌氧血培养分析

Analysis of anaerobic blood cultures in burned patients.

作者信息

Regules Jason A, Carlson Misty D, Wolf Steven E, Murray Clinton K

机构信息

Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.

出版信息

Burns. 2007 Aug;33(5):561-4. doi: 10.1016/j.burns.2006.10.390. Epub 2007 May 9.

Abstract

The utility of anaerobic blood culturing is often debated in the general population, but there is limited data on the modern incidence, microbiology, and utility of obtaining routine anaerobic blood cultures for burned patients. We performed a retrospective review of the burned patients electronic medical records database for all blood cultures drawn between January 1997 and September 2005. We assessed blood cultures for positivity, organisms identified, and growth in aerobic or anaerobic media. 85,103 blood culture sets were drawn, with 4059 sets from burned patients. Three hundred and forty-five single species events (619 total blood culture isolates) were noted in 240 burned patients. For burned patients, four isolates were obligate anaerobic bacteria (all Propionibacterium acnes). Anaerobic versus aerobic culture growth was recorded in 310 of 619 (50.1%) burned patient blood culture sets. 46 (13.5%) of the identified organisms, most of which were not obligate anaerobic bacteria, were identified from solely anaerobic media. The results of our study suggest that the detection of significant anaerobic bacteremia in burned patients is very rare and that anaerobic bottles are not needed in this population for that indication. However anaerobic blood cultures systems are also able to detect facultative and obligate aerobic bacteria; therefore, the deletion of the anaerobic culture medium may have deleterious clinical impact.

摘要

厌氧血培养在普通人群中的实用性常常存在争议,但关于烧伤患者进行常规厌氧血培养的现代发病率、微生物学及实用性的数据有限。我们对1997年1月至2005年9月期间所有抽取的血培养的烧伤患者电子病历数据库进行了回顾性研究。我们评估血培养的阳性情况、鉴定出的微生物以及在需氧或厌氧培养基中的生长情况。共抽取了85103套血培养,其中4059套来自烧伤患者。在240名烧伤患者中发现了345个单菌种事件(共619株血培养分离菌)。对于烧伤患者,有4株分离菌为专性厌氧菌(均为痤疮丙酸杆菌)。在619套烧伤患者血培养中,有310套(50.1%)记录了厌氧与需氧培养的生长情况。46株(13.5%)鉴定出的微生物(其中大多数不是专性厌氧菌)仅从厌氧培养基中鉴定出来。我们的研究结果表明,烧伤患者中显著厌氧菌血症的检测非常罕见,对于该指征,该人群不需要厌氧瓶。然而,厌氧血培养系统也能够检测兼性和专性需氧菌;因此,删除厌氧培养基可能会产生有害的临床影响。

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