评价疑似心内膜炎患者血培养延长孵育时间并进行盲传代培养。
An evaluation of extended incubation time with blind subculture of blood cultures in patients with suspected endocarditis.
机构信息
Department of Pathology and Laboratory Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia.
出版信息
Can J Infect Dis Med Microbiol. 2006 May;17(3):186-8. doi: 10.1155/2006/284019.
BACKGROUND
In a small proportion of patients, bacterial endocarditis is due to organisms that grow slowly and may not be recovered in conventional blood cultures incubated for five days. This has led to recommendations for prolonged incubation and routine subculture of negative cultures.
OBJECTIVE
The above-mentioned approach is evaluated.
METHOD
The microbiology of all blood cultures subjected to prolonged incubation and the charts of individuals who had organisms recovered after five days were evaluated to determine their clinical significance.
RESULTS
In all, 507 blood cultures were handled using an extended incubation and blind subculture protocol. Fifty-three blood cultures in 27 patients were positive. Blood cultures were positive after five days in only five cases; patient outcomes were not affected by the results in any of these cases, although several fastidious organisms (ie, Haemophilus paraphrophilus and Haemophilus parainfluenzae) were recovered in the first five days of incubation.
CONCLUSION
Prolonged incubation and blood subcultures in patients with suspected endocarditis or infections due to fastidious organisms do not represent a wise use of increasingly scarce resources.
背景
在一小部分患者中，细菌性心内膜炎是由生长缓慢的病原体引起的，这些病原体可能无法在常规培养五天的血液培养物中恢复。这导致了延长孵育时间和常规培养阴性培养物的建议。
目的
评估上述方法。
方法
评估所有延长孵育和盲法亚培养的血液培养物的微生物学和在五天后恢复病原体的个体的图表，以确定其临床意义。
结果
总共处理了 507 份血液培养物，采用了延长孵育和盲法亚培养方案。27 名患者中有 53 份血培养阳性。仅在五例患者中，五天后血培养呈阳性；在这些情况下，患者的结局都不受这些结果的影响，尽管在孵育的前五天中恢复了几种苛刻的病原体（即副流感嗜血杆菌和嗜沫嗜血杆菌）。
结论
对于疑似心内膜炎或由苛刻病原体引起的感染患者，延长孵育时间和血液亚培养并不能明智地利用日益稀缺的资源。
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