Ye Hui, Su Fei-Fei, Cui Xiao-Ya, Guo Xiu-Xiu, Zhu Tian-Ye, Kong De-Yong, Miao Xing-Guo
Department of Infectious Diseases, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, The Second Affiliated Hospital of Shanghai University, Zhejiang, 325000, China.
Department of Infectious Diseases, The Sixth People's Hospital of Wenzhou, Nanbaixiang Street, Ouhai District, Wenzhou City, 325000, Zhejiang Province, China.
Infect Dis Ther. 2023 Nov;12(11):2611-2620. doi: 10.1007/s40121-023-00883-1. Epub 2023 Oct 23.
Bloodstream infection (BSI) is a significant factor contributing to hospitalization and high mortality rates among human immunodeficiency virus(HIV)-positive patients. Therefore, the timely detection of this condition is of utmost importance. Blood culture is considered the gold standard for diagnosing BSIs. Currently, BD BACTEC™ Plus Aerobic/F culture bottles and the BD BACTEC™ Myco/F Lytic culture bottles can be used for blood culture. This study aimed to evaluate the efficacy of two different types of culture bottles in diagnosing BSIs in patients with HIV.
A retrospective analysis was conducted on HIV-positive patients hospitalized in the Infection Department of Wenzhou Central Hospital between July 2019 and October 2021. A total of 246 pairs of blood samples were included, consisting of an aerobic culture vial and a Myco/F culture vial. Blood culture results and clinical diagnosis were utilized to identify the presence of BSI.
Out of 246 cases, 84 cases had positive blood cultures. Fungal BSIs, particularly Talaromyces marneffei BSIs, were the most prevalent among patients with HIV. The positive rate of Myco/F culture bottles (89.29%) was significantly higher compared with aerobic culture bottles (69.05%; P = 0.001). In the diagnosis of fungal BSIs, the positive rate of Myco/F culture bottles was 88.57%, which was significantly higher than that of aerobic culture bottles (72.86%; P = 0.018). The Myco/F culture bottle has more advantages in diagnosing Talaromyces marneffei BSIs (P=0.028). In addition, mycobacteria were exclusively detected in Myco/F culture bottles.
Fungal BSIs are the predominant type of infections in HIV-positive patients. Myco/F culture bottles exhibit noteworthy attributes of high positive rate in diagnosing HIV combined with BSI. These advantages are conducive to obtaining accurate culture results and minimizing missed diagnoses.
血流感染（BSI）是导致人类免疫缺陷病毒（HIV）阳性患者住院和高死亡率的重要因素。因此，及时检测这种情况至关重要。血培养被认为是诊断BSI的金标准。目前，BD BACTEC™ Plus需氧/F培养瓶和BD BACTEC™ Myco/F溶解培养瓶可用于血培养。本研究旨在评估两种不同类型培养瓶在诊断HIV患者BSI中的效果。
对2019年7月至2021年10月在温州中心医院感染科住院的HIV阳性患者进行回顾性分析。共纳入246对血样，包括一个需氧培养瓶和一个Myco/F培养瓶。利用血培养结果和临床诊断来确定是否存在BSI。
在246例病例中，84例血培养呈阳性。真菌性BSI，尤其是马尔尼菲篮状菌BSI，在HIV患者中最为常见。Myco/F培养瓶的阳性率（89.29%）显著高于需氧培养瓶（69.05%；P = 0.001）。在诊断真菌性BSI时，Myco/F培养瓶的阳性率为88.57%，显著高于需氧培养瓶（72.86%；P = 0.018）。Myco/F培养瓶在诊断马尔尼菲篮状菌BSI方面具有更多优势（P = 0.028）。此外，分枝杆菌仅在Myco/F培养瓶中被检测到。
真菌性BSI是HIV阳性患者中主要的感染类型。Myco/F培养瓶在诊断HIV合并BSI方面具有阳性率高的显著特点。这些优势有助于获得准确的培养结果并减少漏诊。
