Wilson M L, Weinstein M P, Mirrett S, Reimer L G, Feldman R J, Chuard C R, Reller L B
Department of Pathology and Laboratory Service, Denver Health & Hospitals, Colorado 80204, USA.
J Clin Microbiol. 1995 Sep;33(9):2265-70. doi: 10.1128/jcm.33.9.2265-2270.1995.
FAN medium was formulated to improve microbial recovery, particularly for fastidious microorganisms and for microorganisms causing sepsis in patients receiving antimicrobial therapy. In a controlled clinical evaluation performed at four university-affiliated hospitals, FAN anaerobic bottles were compared with standard anaerobic bottles for yield, speed of detection of microbial growth, and detection of septic episodes. A total of 10,431 blood culture sets were received; both anaerobic bottles of 7,694 blood culture sets were adequately filled with blood. Altogether, 925 isolates were recovered: 557 that were the cause of sepsis, 99 that were indeterminate as the cause of sepsis, and 269 contaminants. More Staphylococcus aureus (P < 0.001), coagulase-negative staphylococci (P < 0.001), Escherichia coli (P < 0.02), and all microorganisms combined (P < 0.005) were recovered from FAN bottles; more nonfermentative gram-negative bacilli (P < 0.05), Torulopsis glabrata (P < 0.001), and other yeasts (P < 0.01) were recovered from standard bottles. Growth of S. aureus (P < 0.001), coagulase-negative staphylococci (P < 0.001), Enterococcus faecalis (P < 0.025), streptococci other than Streptococcus pneumoniae (P < 0.01), and all microorganisms combined (P < 0.001) was detected earlier in standard bottles; growth of more isolates of E. coli (P < 0.05) and anaerobic bacteria (P < 0.01) was detected earlier in FAN bottles. The mean times to detection were 14.2 and 16.1 h for standard and FAN bottles, respectively. More septic episodes caused by S. aureus (P < 0.001), coagulase-negative staphylococci (P < 0.005), members of the family Enterobacteriaceae (P < 0.02), and all microorganisms combined (P < 0.02) were detected in FAN bottles; more septic episodes caused by nonfermentative gram-negative bacilli (P < 0.025) and yeasts (P < 0.005) were detected in standard bottles. In summary, more isolates (except for strict aerobes) were recovered from FAN bottles than from standard anaerobic bottles. Similarly, significant more septic episodes (except for those caused by strict aerobes) were detected with FAN bottles than with standard anaerobic bottles. With the exception of E. coli and anaerobic bacteria, growth of more isolates was detected earlier in standard anaerobic bottles.
FAN培养基的配方旨在提高微生物回收率，特别是对于苛求菌以及接受抗菌治疗患者中引起败血症的微生物。在四家大学附属医院进行的一项对照临床评估中，对FAN厌氧瓶与标准厌氧瓶在微生物生长产量、检测速度以及败血症发作检测方面进行了比较。共收到10431套血培养标本；7694套血培养标本的两个厌氧瓶均充分装满血液。总共分离出925株菌株：557株为败血症病因，99株败血症病因不明，269株为污染物。从FAN瓶中分离出的金黄色葡萄球菌（P<0.001）、凝固酶阴性葡萄球菌（P<0.001）、大肠杆菌（P<0.02）以及所有微生物合计（P<0.005）更多；从标准瓶中分离出的非发酵革兰阴性杆菌（P<0.05）、光滑念珠菌（P<0.001）和其他酵母菌（P<0.01）更多。金黄色葡萄球菌（P<0.001）、凝固酶阴性葡萄球菌（P<0.001）、粪肠球菌（P<0.025）、除肺炎链球菌外的链球菌（P<0.01）以及所有微生物合计（P<0.001）在标准瓶中更早被检测到生长；更多大肠杆菌菌株（P<0.05）和厌氧菌（P<0.01）在FAN瓶中更早被检测到生长。标准瓶和FAN瓶的平均检测时间分别为 14.2小时和16.1小时。在FAN瓶中检测到更多由金黄色葡萄球菌（P<0.001）、凝固酶阴性葡萄球菌（P<0.005）、肠杆菌科成员（P<0.02）以及所有微生物合计（P<0.02）引起的败血症发作；在标准瓶中检测到更多由非发酵革兰阴性杆菌（P<0.025）和酵母菌（P<0.005）引起的败血症发作。总之，从FAN瓶中回收的分离株（严格需氧菌除外）比从标准厌氧瓶中更多。同样，与标准厌氧瓶相比，FAN瓶检测到的败血症发作显著更多（严格需氧菌引起的发作除外）。除大肠杆菌和厌氧菌外，更多分离株在标准厌氧瓶中更早被检测到生长。
