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血培养阳性标本中病原菌的快速细菌鉴定及药敏试验方法。

Rapid Bacterial Identification and Drug Sensitivity Test Methods for Pathogens in Positive Blood Cultures.

出版信息

Clin Lab. 2022 Oct 1;68(10). doi: 10.7754/Clin.Lab.2022.211247.

Abstract

BACKGROUND

The turnover time of positive blood culture using traditional methods takes too long. This study aimed to evaluate rapid direct identification and drug sensitivity test methods for pathogens in positive blood cultures.

METHODS

A total of 403 blood culture bottles were used to compare the rapid identification methods and drug sensitivity tests for pathogens causing bloodstream infections. Bacteria were enriched using separator gel tubes and were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. In addition, bacteria were also identified using an established traditional method for comparison. The sensitivity of gram-negative bacilli against antibiotics was tested using Rapid Bacterial Test Strips or the VITEK 2 Compact system.

RESULTS

The accuracy was 81.8% in 403 bacteria, of which 71% (132/186) and 96.3% (209/217) were gram-positive and gram-negative bacteria, respectively. The gram-positive bacteria were primarily Staphylococcus aureus and coagulase-negative Staphylococcus. The gram-negative bacteria were primarily Escherichia coli and Klebsiella pneumonia. Compared with routine drug sensitivity testing methods, the coincidence rate of direct drug sensitivity testing for classifying the bacteria was 98.6% (1,325/1,344). The average rapid bacterial identification time was 1.5 hours, and the direct drug sensitivity test took - 8.5 hours.

CONCLUSIONS

The present study showed that direct identification and rapid drug sensitivity testing can be performed on the same day and can be completed 1 or 2 days ahead of routine methods, thereby assisting in providing earlier drug options for anti-infective therapy.

摘要

背景

传统方法检测阳性血培养的周转时间过长。本研究旨在评估快速直接鉴定和药敏试验方法在阳性血培养中病原体的应用。

方法

使用分离器凝胶管对 403 个血培养瓶中的血流感染病原体进行快速鉴定方法和药敏试验比较。使用基质辅助激光解吸/电离飞行时间质谱法进行细菌鉴定。此外,还使用建立的传统方法进行比较。使用 Rapid Bacterial Test Strips 或 VITEK 2 Compact 系统测试革兰氏阴性菌对抗生素的敏感性。

结果

在 403 株细菌中,准确率为 81.8%,其中革兰氏阳性菌和革兰氏阴性菌的准确率分别为 71%(132/186)和 96.3%(209/217)。革兰氏阳性菌主要为金黄色葡萄球菌和凝固酶阴性葡萄球菌。革兰氏阴性菌主要为大肠埃希菌和肺炎克雷伯菌。与常规药敏试验方法相比,直接药敏试验对细菌分类的符合率为 98.6%(1325/1344)。快速细菌鉴定的平均时间为 1.5 小时,直接药敏试验耗时 8.5 小时。

结论

本研究表明,直接鉴定和快速药敏试验可以在同一天进行,比常规方法提前 1 至 2 天完成,从而有助于为抗感染治疗提供更早的药物选择。

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