Fan K, Morris A J, Reller L B
Clinical Microbiology Laboratory, Duke University Medical Center, Durham, North Carolina 27710.
J Clin Microbiol. 1993 Aug;31(8):2233-5. doi: 10.1128/jcm.31.8.2233-2235.1993.
Over 20 months, we prospectively assessed the yield of cultures for Salmonella, Shigella, and Campylobacter spp. from adults and children. In the first 10 months, 53% (567 of 1,097) of specimens from adults were from patients who had been in the hospital for > 3 days. Overall, only 2.6% (29 of 1,097) of specimens contained pathogens, and all were from patients who had been in the hospital for < or = 3 days. Over the second 10 months, specimens from adults in the hospital for > 3 days were not cultured unless special reasons existed. Thirty percent (368 of 1,229) of specimens were rejected. Concurrently, 7.5% (51 of 677) of stool specimens from children were positive. Only one positive specimen came from a child who had been in the hospital for > 3 days. Neither stool consistency nor fecal leukocytes were useful predictors for the presence of an enteric pathogen. We recommend that specimens from both adults and children in the hospital for > 3 days not be cultured unless there are delineated plausible clinical or epidemiological reasons to do so.
在20个月的时间里，我们前瞻性地评估了从成人和儿童中培养沙门氏菌、志贺氏菌和弯曲杆菌属细菌的阳性率。在最初的10个月里，来自成人的标本中有53%（1097份中的567份）来自住院超过3天的患者。总体而言，只有2.6%（1097份中的29份）的标本含有病原体，且所有这些标本均来自住院时间小于或等于3天的患者。在随后的10个月里，除非有特殊原因，否则不再对住院超过3天的成人标本进行培养。30%（1229份中的368份）的标本被拒收。同时，儿童粪便标本中有7.5%（677份中的51份）呈阳性。只有一份阳性标本来自住院超过3天的儿童。粪便的稠度和粪便白细胞都不是肠道病原体存在的有效预测指标。我们建议，除非有明确合理的临床或流行病学原因，否则不应培养住院超过3天的成人和儿童的标本。
