Zhu Li-Wei, Yang Xue-Mei, Xu Xiao-Qin, Xu Jian, Lu Huang-Jun, Yan Li-Xing
Department of Quality control, Zhejiang Province Blood Center, Huangzhou 310006, Zhejiang Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008 Oct;16(5):1207-10.
This study was aimed to analyze the results of false positive reaction in bacterial detection of blood samples with BacT/ALERT 3D system, to evaluate the specificity of this system, and to decrease the false positive reaction. Each reaction flasks in past five years were processed for bacteria isolation and identification. When the initial cultures were positive, the remaining samples and the corresponding units were recultured if still available. 11395 blood samples were detected. It is worthy of note that the incubator temperature should be stabilized, avoiding fluctuation; when the cultures were alarmed, the reaction flasks showed be kept some hours for further incubation so as to trace a sharply increasing signal to support the judgement of true bacterial growth. The results indicated that 122 samples (1.07%) wee positive at initial culture, out of them 107 samples (88.7%) were found bacterial, and 15 samples (12.3%) were found nothing. The detection curves of positive samples resulted from bacterial growth showed ascent. In conclusion, maintenance of temperature stability and avoidance of temperature fluctuation in incubator could decrease the occurrence of false-positive reaction in detection process. The reaction flasks with positive results at initial culture should be recultured, and whether existence of a sharply ascending logarilhimic growth phase in bacterial growth curve should be further detected, which are helpful to distinguish false-positive reactions from true positive, and thus increase the specificity of the BacT/ALERT system.
本研究旨在分析采用BacT/ALERT 3D系统检测血样细菌时假阳性反应的结果,评估该系统的特异性,并减少假阳性反应。对过去五年中的每个反应瓶进行细菌分离和鉴定处理。当初始培养结果为阳性时,若剩余样本及相应单位仍可获得,则进行再次培养。共检测了11395份血样。值得注意的是,培养箱温度应保持稳定,避免波动;当培养出现警报时,反应瓶应继续培养数小时,以便追踪急剧上升的信号以支持对真正细菌生长的判断。结果表明,122份样本(1.07%)初始培养呈阳性,其中107份样本(88.7%)检测到细菌,15份样本(12.3%)未检测到细菌。由细菌生长导致的阳性样本检测曲线呈上升趋势。总之,保持培养箱温度稳定并避免温度波动可减少检测过程中假阳性反应的发生。对初始培养呈阳性结果的反应瓶应进行再次培养,并进一步检测细菌生长曲线中是否存在急剧上升的对数生长期,这有助于区分假阳性反应和真阳性反应,从而提高BacT/ALERT系统的特异性。