Duggal S, Jesaiwal S K, Tandon N, Chugh T D
Department of Microbiology, Baba Saheb Ambedkar Hospital, Rohini, Delhi-110085, India.
Indian J Med Microbiol. 2011 Jul-Sep;29(3):283-7. doi: 10.4103/0255-0857.83914.
This was a prospective study planned in a super-specialty hospital in Delhi to reduce turnaround times of identification-susceptibility results of positive blood cultures.
One hundred consecutive single morphology non-duplicate cultures were inoculated on Becton Dickinson Phoenix™ panels by growth recovered directly from liquid BACTEC™ media and after pure growth on solid media.
Complete concordance was observed in 72.4% of gram-negative and 45.8% of gram-positive isolates. For gram-negative isolates, categorical agreement (CA) was >83% and essential agreement (EA) was >96% among all antibiotics tested, very major errors (VME) were 0.13%, major errors (ME) 0.54%, and minor errors (MiE) were 3.01%. For gram-positive isolates, VME was 0.73%, 1.10% MiE and no ME. It was observed that average time from receipt of specimen to release of reports was 30:34 h and 32 h for gram-negative and gram-positive isolates if reports of "Direct" panels were to be released.
By direct panel inoculation, a decrease of at least 18-20 h in turnaround time was observed compared with the standard method. This helps early change to effective antibiotic therapy and also reduces the expenditure incurred for a patient's hospital stay by average Rs 20,000 ($443) per day.
这是一项在德里一家超级专科医院开展的前瞻性研究，旨在缩短阳性血培养鉴定药敏结果的周转时间。
将100份连续的单一形态非重复培养物，通过直接从液体BACTEC™培养基中回收的生长物以及在固体培养基上纯培养后，接种到Becton Dickinson Phoenix™鉴定板上。
在72.4%的革兰氏阴性菌和45.8%的革兰氏阳性菌分离株中观察到完全一致。对于革兰氏阴性菌分离株，在所有测试抗生素中，分类一致性（CA）>83%，必需一致性（EA）>96%，非常重大错误（VME）为0.13%，重大错误（ME）为0.54%，微小错误（MiE）为3.01%。对于革兰氏阳性菌分离株，VME为0.73%，MiE为1.10%，无ME。观察到，如果要发布“直接”鉴定板的报告，革兰氏阴性菌和革兰氏阳性菌分离株从接收标本到发布报告的平均时间分别为30:34小时和32小时。
与标准方法相比，通过直接接种鉴定板，周转时间至少缩短了18 - 20小时。这有助于尽早更换为有效的抗生素治疗，并且还能使患者住院期间的每日平均费用降低约20,000卢比（443美元）。
