Department of Pathology, Case Western Reserve Universitygrid.67105.35 School of Medicine, Cleveland, Ohio, USA.
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA.
J Clin Microbiol. 2022 Sep 21;60(9):e0050022. doi: 10.1128/jcm.00500-22. Epub 2022 Aug 30.
The utility of anaerobic blood culture bottles remains controversial, especially for specimens from children. Data are limited on the inclusion of an anaerobic bottle as part of a blood culture "set" when using contemporary blood culture instruments and media. Here, we evaluated the clinical utility of anaerobic blood culture bottles (FN Plus) and aerobic bottles (FA Plus) for the BacT/Alert Virtuo blood culture system (bioMérieux). A total of 158,710 bottles collected between November 2018 and October 2019 were evaluated. There were 6,652 positive anaerobic bottles, of which 384 (5.8%) contained 403 obligate anaerobes. In patients <19 years old, there were 389 positive anaerobic bottles, with 15 (1.8%) containing 16 obligate anaerobes. If not for anaerobic bottles, all but 8 obligate anaerobes would have gone undetected. Furthermore, anaerobic bottles were advantageous for some facultative anaerobes. Staphylococcus aureus from anaerobic bottles demonstrated statistically significant increased recovery (1,992 anaerobic versus 1,901 aerobic bottles, 0.009) and faster mean time to positivity (1,138 versus 1,174 min, 0.027). Only 25 microorganisms had statistically significant improved recovery and/or faster time to positivity from aerobic versus anaerobic bottles, suggesting anaerobic bottles offer comparable growth for most species. Finally, if only an aerobic bottle had been collected, 2,027 fewer positive cultures would have been detected and 7,452 fewer isolates would have been reported, including cultures with S. aureus (413 isolates, 10.6% less), Pseudomonas aeruginosa (9 isolates, 3.1% less) and Escherichia coli (193 isolates, 14.0% less). Taken together, these findings support the practice of routinely including an anaerobic bottle for blood culture collection.
厌氧菌培养瓶的实用性仍存在争议，尤其是对于儿童标本而言。在使用现代血培养仪器和培养基时，将厌氧菌培养瓶作为血培养“套装”的一部分纳入其中的数据有限。在这里，我们评估了 BacT/Alert Virtuo 血培养系统（bioMérieux）中厌氧菌培养瓶（FN Plus）和需氧瓶（FA Plus）的临床实用性。共评估了 2018 年 11 月至 2019 年 10 月期间收集的 158710 个培养瓶。有 6652 个厌氧菌培养瓶呈阳性，其中 384 个（5.8%）含有 403 种严格厌氧菌。在<19 岁的患者中，有 389 个厌氧菌培养瓶呈阳性，其中 15 个（1.8%）含有 16 种严格厌氧菌。如果没有厌氧菌培养瓶，除了 8 种严格厌氧菌之外，其他的都无法被检测到。此外，厌氧菌培养瓶对一些兼性厌氧菌也有优势。从厌氧菌培养瓶中分离出的金黄色葡萄球菌在统计学上显示出显著增加的回收率（1992 个厌氧菌瓶和 1901 个需氧瓶，0.009）和更快的平均阳性时间（1138 分钟和 1174 分钟，0.027）。只有 25 种微生物从需氧瓶到厌氧菌瓶的回收率和/或阳性时间有统计学意义上的提高，这表明厌氧菌瓶对大多数物种的生长都具有可比性。最后，如果只收集需氧瓶，那么将检测到的阳性培养物将减少 2027 个，报告的分离株将减少 7452 个，包括金黄色葡萄球菌（413 株，减少 10.6%）、铜绿假单胞菌（9 株，减少 3.1%）和大肠埃希菌（193 株，减少 14.0%）。总的来说，这些发现支持常规收集厌氧菌培养瓶进行血培养的做法。
