CAJ | 학술논문

目的为进一步缩短实验室菌血症诊断时间,评估联合法阳性血培养直接鉴定药敏试验的可行性.方法将血培养瓶放人BACTEC 9000血培养系统进行培养筛选.选取65份含革兰阴性杆菌的阳性血培养瓶进行试验.抽取培养液,用BD真空分离管离心分离血细胞.在收集到足量菌液后,用Phoenix 100 NMIC/ID-4革兰阴性菌鉴定药敏卡做0.25 McF和0.5 McF直接鉴定药敏试验.用标准方法及哑培养后的鉴定药敏试验对直接鉴定药敏试验进行评估.结果 0.25 McF直接鉴定试验,65株中的63株(96.9%)准确鉴定.0.5 MeF直接鉴定试验,65株中的59株(90.8%)准确鉴定.0.25 McF直接药敏试验标准符合率97.8%以上.0.5 McF直接药敏试验标准符合率95.9%以上.KB法血标本直接药敏试验标准符合率96.4%以上,但微小错误率高于联合药敏法.结论采用0.25 McF、0.5 McF两种菌液浓度法进行血培养阳性标本鉴定药敏试验是切实可行的.联合法0.25 McF菌液浓度的直接鉴定药敏试验具有明显优势,对临床具有很好的及时、有效地指引作用.
목적 위진일보축단실험실균혈증진단시간,평고연합법양성혈배양직접감정약민시험적가행성.방법 장혈배양병방인BACTEC 9000혈배양계통진행배양사선.선취65빈함혁란음성간균적양성혈배양병진행시험.추취배양액,용BD진공분리관리심분리혈세포.재수집도족량균액후,용Phoenix 100 NMIC/ID-4혁란음성균감정약민잡주0.25 McF화0.5 McF직접감정약민시험.용표준방법급아배양후적감정약민시험대직접감정약민시험진행평고.결과 0.25 McF직접감정시험,65주중적63주(96.9%)준학감정.0.5 MeF직접감정시험,65주중적59주(90.8%)준학감정.0.25 McF직접약민시험표준부합솔97.8%이상.0.5 McF직접약민시험표준부합솔95.9%이상.KB법혈표본직접약민시험표준부합솔96.4%이상,단미소착오솔고우연합약민법.결론 채용0.25 McF、0.5 McF량충균액농도법진행혈배양양성표본감정약민시험시절실가행적.연합법0.25 McF균액농도적직접감정약민시험구유명현우세,대림상구유흔호적급시、유효지지인작용.
Objective To reduce the turnaround time for laboratory diagnosis of bacteremia, the feasibility of rapid identification and susceptibility testing using samples taken directly from positive blood culture bottles was evaluated. Methods The growth of microorganisms in blood culture bottles was screened by the BACTEC 9000 blood culture system. 65 positive blood culture bottles containing gram-negative bacteria were adopted to test. Culture fluid was injected into BD SST vacutainer and centrifuged to pellet blood cells. After collecting required McFarland units, they were cultured on Phoenix 100 NMIC/ID-4(identification-gram-negative bacteria and susceptibility testing) cards using 0.25 McF and 0.5 McF methods respectively. They were also evaluated by the standard method, involving subculture tests from positive blood culture bottles. Results 63 of 65 gram-negative bacteria (96. 9% ) were correctly identified with 0. 25 McF method. 59 of 65 gram-negative bacteria(90.8% ) were correctly identified with 0.5 McF method. For antimicrobial susceptibility testing, the 0.25 McF direct method had an agreement rate more than 94% , the 0.5 McF method was more than 85.7% and direct blood sample KB method was more than 93.8% compared to the standard method. But the overall minor error rate in susceptibility testing of direct blood sample KB method is higher than other methods. Conclusion Applying 0. 25 McF and 0. 5 McF rapid identification and susceptibility test was practical. During to possessing more prominent advantages, laboratory put the 0. 25 McF direct method into practice had a timely, remarkable significance.