Brown D F, Warren R E
Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Hills Road, Cambridge.
J Clin Pathol. 1990 Sep;43(9):777-9. doi: 10.1136/jcp.43.9.777.
Six hundred and sixteen blood samples from patients with haematological malignancy were each distributed equally among three identical cells in a Malthus Microbiological Growth Analyser. The mean (SD) volumes inoculated into sets in which one, two, or three of the three bottles were positive were 37.7 (10.1) ml, 37.4 (12.9) ml, and 37.7 (10.5) ml, respectively. Overall, clinically important organisms were isolated from one bottle only with 18 cultures, from two bottles only with 19 cultures, and from all three bottles in a set with 104 cultures. If the yield from a single bottle inoculated with a mean volume of 12.6 ml blood is taken as 100%, the yield from 25.2 ml in two bottles was 110.7% and the yield from 37.7 ml in three bottles was 115.6%. The increased yield from increased volume was considerably lower than that reported from unselected groups of patients, which suggests that the magnitude of bacteriaemia is greater in patients with neutropenia. The isolation of infecting organisms from the blood of patients with neutropenia is, however, particularly important in directing chemotherapy and consequently 45 ml blood samples from these patients continue to be requested.
从血液系统恶性肿瘤患者中采集的616份血样，每份均被等分到马尔萨斯微生物生长分析仪中的三个相同培养瓶中。在三个培养瓶中，一个、两个或三个培养瓶呈阳性的情况下，接种到培养瓶中的平均（标准差）血量分别为37.7（10.1）ml、37.4（12.9）ml和37.7（10.5）ml。总体而言，仅从一个培养瓶中分离出具有临床意义的微生物的培养物有18份，仅从两个培养瓶中分离出的有19份，从一组中的所有三个培养瓶中分离出的有104份。如果将接种平均血量为12.6 ml血液的单个培养瓶的培养物产量视为100%，那么接种25.2 ml血液的两个培养瓶的产量为110.7%，接种37.7 ml血液的三个培养瓶的产量为115.6%。因血量增加而带来的产量增加幅度明显低于未经过筛选的患者群体所报告的幅度，这表明中性粒细胞减少症患者的菌血症程度更高。然而，从患有中性粒细胞减少症患者的血液中分离出感染性微生物对于指导化疗尤为重要，因此仍要求从这些患者采集45 ml血样。
