Rodwell R L, Leslie A L, Tudehope D I
Department of Haematology, Mater Misericordiae Public Hospitals, Brisbane, Queensland, Australia.
Aust Paediatr J. 1989 Apr;25(2):83-5. doi: 10.1111/j.1440-1754.1989.tb01421.x.
During an 8 month period, 298 evaluations of direct and buffy coat films of peripheral blood for the detection of bacteraemia were undertaken in 287 infants (243 less than 24 h of age and 55 aged between 2 days and 30 days). Bacteraemia was diagnosed by simultaneously drawn aerobic and anaerobic blood cultures. Intracellular organisms were observed in both the direct and buffy coat films of only four of 24 infants with bacteraemia, giving a sensitivity of 17%, specificity of 100% and positive and negative predictive values of 100% and 93%, respectively. Of 12 infants with bacteraemia on the first day of life, eight were asymptomatic when studied, and none of the 12 had positive smears. As two of four infants with positive smears died, it is concluded that in fulminating sepsis the tests seem to correlate with the degree of illness and may give useful information as to the causative organism and the choice of antibiotic. However, as a screening test, the present methodology lacks sensitivity and cost-effectiveness.
在8个月的时间里，对287名婴儿（243名小于24小时龄，55名年龄在2天至30天之间）的外周血直接涂片和血沉棕黄层涂片进行了298次评估，以检测菌血症。通过同时采集需氧和厌氧血培养来诊断菌血症。在24例菌血症婴儿中，仅4例的直接涂片和血沉棕黄层涂片中观察到细胞内微生物，灵敏度为17%，特异性为100%，阳性预测值和阴性预测值分别为100%和93%。在出生第一天患有菌血症的12例婴儿中，8例在接受检查时无症状，12例中无一例涂片呈阳性。由于4例涂片阳性的婴儿中有2例死亡，得出的结论是，在暴发性败血症中，这些检测似乎与疾病程度相关，并且可能提供有关病原体和抗生素选择的有用信息。然而，作为一种筛查试验，目前的方法缺乏灵敏度和成本效益。
