配对血培养和涂片在艾滋病患者播散性鸟分枝杆菌复合群感染诊断中的应用
Utility of paired blood cultures and smears in diagnosis of disseminated Mycobacterium avium complex infections in AIDS patients.
作者信息
Stone B L, Cohn D L, Kane M S, Hildred M V, Wilson M L, Reves R R
机构信息
Denver Disease Control Service, Denver Health and Hospital, Colorado 80204.
出版信息
J Clin Microbiol. 1994 Mar;32(3):841-2. doi: 10.1128/jcm.32.3.841-842.1994.
For 273 patients evaluated for disseminated Mycobacterium avium complex infection, a total of 1,047 mycobacterial blood cultures (MBCs) were submitted; the M. avium complex was recovered from 140 (13%) of the specimens. Results for the paired MBCs were highly concordant: in 392 of 462 (85%) culture sets, both MBCs were negative, in 53 of 462 (11%) sets, both MBCs were positive, and in only 17 of 462 (4%) sets was one culture positive and the other negative. Acid-fast smears were done on sediments from 671 specimens; smears were positive for 4 of 98 (4%) cultures that grew the M. avium complex. A single MBC should be obtained and then repeated if negative and disseminated M. avium complex infection is still clinically suspected. Use of direct acid-fast smears of sediments is not a reliable means of detecting mycobacteremia.
对273例播散性鸟分枝杆菌复合群感染患者进行评估，共送检了1047份分枝杆菌血培养（MBC）标本；140份（13%）标本培养出鸟分枝杆菌复合群。配对的MBC结果高度一致：462组培养中，392组（85%）两份MBC均为阴性，462组中有53组（11%）两份MBC均为阳性，462组中仅有17组（4%）一份培养阳性而另一份阴性。对671份标本的沉淀物进行了抗酸涂片检查；在培养出鸟分枝杆菌复合群的98份培养物中，4份（4%）涂片呈阳性。应采集一份MBC标本，如果结果为阴性且仍临床怀疑播散性鸟分枝杆菌复合群感染，则需重复送检。对沉淀物进行直接抗酸涂片检查并非检测分枝杆菌血症的可靠方法。
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