Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea.
Diagn Microbiol Infect Dis. 2012 Jul;73(3):239-42. doi: 10.1016/j.diagmicrobio.2012.03.022. Epub 2012 Apr 25.
Blood culture is the most valuable laboratory test for the diagnosis of bacteremia and sepsis. The BACTEC FX and BacT/Alert 3D automated blood culture systems are commonly used in Korean health care facilities. A controlled clinical evaluation of the resin-containing BACTEC Plus aerobic (BA) and anaerobic (BN), and the charcoal-containing FAN aerobic (FA) and anaerobic (FN) bottles using blood from intensive care unit (ICU) patients was designed. The performances of these 2 systems with media containing particle absorbing antimicrobial agents were evaluated using the culture positivity rate and time to detection (TTD). TTD was collected using data management systems, either the Epicenter (BD Diagnostic Systems) or the hospital laboratory information system. A total of 1539 four-bottle sets were collected from 270 patients in medical and surgical ICUs. Blood culture samples included 1539 bottles each of BA, BN, FA, and FN, and yielded 113 (7.3%), 90 (5.8%), 104 (6.8%), and 80 (5.2%) positive bacterial or fungal isolates, respectively. There were significant differences between the resin-containing BA and BN samples in culture positivity and also between the charcoal-containing FA and FN samples, especially for Escherichia coli (25/27 versus 17/27, P < 0.05) and Acinetobacter baumannii (14/15 versus 7/15, P < 0.05). Significantly shorter recovery time was observed in BACTEC Plus aerobic bottles than in FAN aerobic bottles (17.2 and 24.7 h, respectively) (P < 0.001).
血培养是诊断菌血症和败血症最有价值的实验室检测方法。BACTEC FX 和 BacT/Alert 3D 自动化血培养系统在韩国医疗机构中广泛应用。本研究设计了一项针对含有树脂的 BACTEC Plus 需氧（BA）和厌氧（BN）瓶，以及含有活性炭的 FAN 需氧（FA）和厌氧（FN）瓶的临床对照评估，评估对象为重症监护病房（ICU）患者的血液。使用含有颗粒吸收型抗菌剂的培养基，评估了这两种系统的培养阳性率和检测时间（TTD）。TTD 通过 Epicenter（BD 诊断系统）或医院实验室信息系统的数据管理系统收集。从内科和外科 ICU 的 270 名患者中采集了 1539 套四瓶套装。血培养样本包括 1539 瓶 BA、BN、FA 和 FN，分别获得 113（7.3%）、90（5.8%）、104（6.8%）和 80（5.2%）阳性细菌或真菌分离株。树脂瓶 BA 和 BN 样本的培养阳性率存在显著差异，活性炭瓶 FA 和 FN 样本的培养阳性率也存在显著差异，尤其是对大肠埃希菌（25/27 对 17/27，P < 0.05）和鲍曼不动杆菌（14/15 对 7/15，P < 0.05）。BACTEC Plus 需氧瓶的恢复时间明显短于 FAN 需氧瓶（分别为 17.2 和 24.7 h）（P < 0.001）。
