Kinnunen U, Syrjala H, Koskela M, Kujala P, Koistinen P
Department of Internal Medicine, Oulu University Hospital, Finland.
Scand J Infect Dis. 1996;28(3):287-92. doi: 10.3109/00365549609027175.
One reason for the underdiagnosis of bacteremia as an etiology of fever in neutropenic patients might lie in inefficient blood culture techniques. This possibility was investigated in a retrospective study by comparing the efficacies of a manual and an automated blood culture system used to detect bacteremia in such patients. All neutropenic fever episodes accompanying all 93 intensive chemotherapy cycles of 26 consecutive patients with acute myelogenous leukemia (AML) enrolled in Finnish Leukemia Group AML 86 trial and treated in Oulu University Hospital over 3 1/2 years were analyzed. The chemotherapy protocol and the supportive care of the patients remained the same during the whole period. In 1990-91 the blood cultures were made manually and in 1992-93 with an automated continuous-monitoring culture screening system. Evaluable febrile episodes numbered 53 during 1990-91 and 73 during 1992-93. There was a statistically significant increase (p < 0.05) of culture-positive episodes, from 21% to 40%, when the continuous-monitoring system was adopted. The new method proved to be better than the manual one in detecting bacteremia of neutropenic patients.
菌血症作为中性粒细胞减少患者发热病因的诊断不足，其原因之一可能在于血培养技术效率低下。在一项回顾性研究中，通过比较用于检测此类患者菌血症的手动和自动血培养系统的效能，对这种可能性进行了调查。分析了芬兰白血病组AML 86试验中连续26例急性髓性白血病（AML）患者在奥卢大学医院接受治疗的93个强化化疗周期中所有伴随的中性粒细胞减少发热发作。在整个期间，患者的化疗方案和支持治疗保持不变。1990 - 1991年采用手动进行血培养，1992 - 1993年使用自动连续监测培养筛查系统。1990 - 1991年期间可评估的发热发作有53次，1992 - 1993年期间有73次。采用连续监测系统时，培养阳性发作从21%增加到40%，有统计学显著增加（p < 0.05）。新方法在检测中性粒细胞减少患者的菌血症方面被证明优于手动方法。
