Yagupsky P, Menegus M A
Department of Clinical Microbiology, University of Rochester (NY) Medical Center.
Arch Pathol Lab Med. 1990 Sep;114(9):923-5.
We examined the occurrence of low-grade Mycobacterium avium-intracellulare bacteremia and Cryptococcus neoformans fungemia in patients with the acquired immunodeficiency syndrome and the consistency of positive cultures obtained using a sensitive blood culture system (Isolator, E. I. Du Pont de Nemours, Wilmington, Del) for the recovery of these organisms. The blood culture records were reviewed, and the proportion of positive blood cultures yielding less than 1 colony-forming unit per milliliter of M avium-intracellulare or C neoformans was calculated. To determine consistency, a period of potentially detectable septicemia was defined as the period between 1 week before the first positive blood culture and the last positive blood culture, providing consecutive positive blood cultures were separated by less than 2 weeks. All positive and negative blood cultures obtained during the period of potentially detectable septicemia were considered in the data analysis. Overall, 40 (16.9%) of 236 cultures positive for M avium-intracellulare and 36 (57.1%) of 63 for C neoformans yielded less than 1 colony-forming unit per milliliter. Mycobacteremia was detected in 52 of 57 periods of potentially detectable septicemia in the first culture and in 56 of 57 in the first two (cumulative detection rates of 91.2% and 98.2%, respectively). Cryptococcemia was detected in 12 of 17 periods of potentially detectable septicemia in the first culture and in 15 of 17 in the first two (cumulative detection rates of 70.6% and 88.2%, respectively). Because of the sensitivity of the blood culture system and the consistency of M avium-intracellulare bacteremia and C neoformans fungemia in patients with the acquired immunodeficiency syndrome, it appears that two blood cultures are sufficient for the detection of most septic episodes caused by these organisms.
我们研究了获得性免疫缺陷综合征患者中低度鸟分枝杆菌-胞内分枝杆菌菌血症和新型隐球菌菌血症的发生情况，以及使用敏感血液培养系统（伊索莱特，E.I.杜邦公司，特拉华州威尔明顿）获得的阳性培养物用于分离这些微生物的一致性。回顾了血液培养记录，并计算了每毫升血液中产生少于1个菌落形成单位的鸟分枝杆菌-胞内分枝杆菌或新型隐球菌阳性血液培养物的比例。为确定一致性，将潜在可检测败血症期定义为首次阳性血液培养前1周与最后一次阳性血液培养之间的时间段，前提是连续的阳性血液培养间隔时间少于2周。数据分析中考虑了在潜在可检测败血症期获得的所有阳性和阴性血液培养物。总体而言，236份鸟分枝杆菌-胞内分枝杆菌阳性培养物中有40份（16.9%）、63份新型隐球菌阳性培养物中有36份（57.1%）每毫升产生少于1个菌落形成单位。在首次培养的57个潜在可检测败血症期中，有52个检测到分枝杆菌血症，在前两次培养的57个中，有56个检测到（累积检出率分别为91.2%和98.2%）。在首次培养的17个潜在可检测败血症期中，有12个检测到隐球菌血症，在前两次培养的17个中，有15个检测到（累积检出率分别为70.6%和88.2%）。由于血液培养系统的敏感性以及获得性免疫缺陷综合征患者中鸟分枝杆菌-胞内分枝杆菌菌血症和新型隐球菌菌血症的一致性，似乎两次血液培养足以检测出由这些微生物引起的大多数败血症发作。
