Rotter M
Infection. 1977;5(1):55-9.
To detect microorganisms in the blood it is necessary not only that the microbiologist uses reliable methods, but also that the clinician takes a sufficient number of blood samples at the right point in time using a correct method for drawing the blood. The best results are obtained if the blood sample is transferred to the culture media at the bedside. The media should contain anticoagulants, osmosis stabilizers and preparations to neutralize the microbial action of the blood (caused by intrinsic and extrinsic factors). Up until now sodium polyanetholsulfonate ("Liquoid") has proved to be the most suitable additive. The procedure used for blood culturing must enable growth of aerobes, anaerobes and microbes with cell-wall damage. Today, modern methods such as radiometry, impedance measurement and microcalorimetry are used or are in the process of being developed which facilitate screening for positive cultures. Antigens, cell-wall constituents and metabolites of bacteria and fungi present in the blood stream can be detected by means of counter-immunoelectrophoresis, the Limulus test and gas chromatography, without culturing being necessary. Concentration techniques such as filtration and centrifugation are also being refined to enable a more reliable and earlier detection of septicemia.
为了检测血液中的微生物,不仅微生物学家需要使用可靠的方法,临床医生还必须在正确的时间点使用正确的采血方法采集足够数量的血样。如果在床边将血样转移到培养基中,则可获得最佳结果。培养基应含有抗凝剂、渗透稳定剂以及中和血液微生物作用(由内在和外在因素引起)的制剂。到目前为止,聚茴香脑磺酸钠(“利可君”)已被证明是最合适的添加剂。用于血培养的程序必须能够使需氧菌、厌氧菌以及细胞壁受损的微生物生长。如今,诸如放射测量法、阻抗测量法和微量量热法等现代方法正在使用或正在开发中,这些方法有助于筛选阳性培养物。无需培养,通过对流免疫电泳、鲎试剂检测法和气相色谱法就可以检测出血液中存在的细菌和真菌的抗原、细胞壁成分及代谢产物。诸如过滤和离心等浓缩技术也在不断完善,以便能够更可靠、更早地检测败血症。