Katzap Roberta M, Pagnussatti Vany Elisa, Figueiredo Ana Elizabeth, Motta Julia Gabriela, d'Avila Domingos O, da Costa Bartira Ercília Pinheiro, Poli-de-Figueiredo Carlos Eduardo
Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nephrology), FAMED/IPB/FFARM/FAENFI/HSL, Porto Alegre, RS, Brazil.
Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nephrology), FAMED/IPB/FFARM/FAENFI/HSL, Porto Alegre, RS, Brazil
Perit Dial Int. 2017 May-Jun;37(3):342-344. doi: 10.3747/pdi.2016.00174.
Patients with chronic kidney disease on peritoneal dialysis (PD) are susceptible to infections, with peritonitis being the primary cause of dropout. Peritoneal fluid culture is one of the essential elements for proper diagnosis and peritonitis treatment. The aim of this study was to compare the time required to obtain a positive culture using different laboratory methods. An cross-sectional study was conducted comparing different techniques for preparation and culture of bacteria in peritoneal fluid. The research was carried out with 21 sterile dialysis bags and 21 PD bags containing peritoneal fluid drained from patients without peritonitis. Fluids from the 42 PD bags were contaminated by injecting a coagulase-negative suspension and then prepared for culture using 4 distinct techniques: A - direct culture; B - post-centrifugation culture; C - direct culture after 4 h sedimentation; and D - culture after 4 h sedimentation and centrifugation. This was followed by seeding. In the 21 contaminated sterile bags, mean times to obtain a positive culture with techniques D (19.6 h ± 2.6) and C (19.1 h ± 2.3) were longer than with technique A (15.8 h ± 3.0; < 0.01), but not statistically different from group B (19.0 h ± 3.2). The same occurred in the 21 bags drained from patients, with mean times for techniques D (14.0 h ± 1.9) and C (14.5 h ± 1.7) being longer than technique A (12.22 h ± 1.94; < 0.05) but not statistically different from technique B (13.2 h ± 1.3). The sedimentation and centrifugation steps seem to be unnecessary and may delay antibiotic sensitivity test results by approximately 8 hours.
接受腹膜透析（PD）的慢性肾病患者易发生感染，腹膜炎是导致患者退出治疗的主要原因。腹膜液培养是正确诊断和治疗腹膜炎的关键要素之一。本研究旨在比较使用不同实验室方法获得阳性培养结果所需的时间。开展了一项横断面研究，比较腹膜液中细菌的不同制备和培养技术。研究使用了21个无菌透析袋和21个装有从无腹膜炎患者引流的腹膜液的腹膜透析袋。通过注入凝固酶阴性悬液污染42个腹膜透析袋中的液体，然后使用4种不同技术进行培养准备：A - 直接培养；B - 离心后培养；C - 沉淀4小时后直接培养；D - 沉淀4小时并离心后培养。随后进行接种。在21个污染的无菌袋中，采用技术D（19.6小时± 2.6）和C（19.1小时± 2.3）获得阳性培养结果的平均时间长于技术A（15.8小时± 3.0；P<0.01），但与B组（19.0小时± 3.2）无统计学差异。从患者引流的21个袋子中情况相同，技术D（14.0小时± 1.9）和C（14.5小时± 1.7）的平均时间长于技术A（12.22小时± 1.94；P<0.05），但与技术B（13.2小时± 1.3）无统计学差异。沉淀和离心步骤似乎没有必要，可能会使抗生素敏感性测试结果延迟约8小时。
