血培养阳性报警时间对临床病原菌鉴别的意义(1)
【摘要】 目的：研究与分析血培养阳性报警时间对临床病原菌鉴别的意义。方法：选取2016年
2月-2017年2月本院发热患者送检病原微生物室的血培养标本为研究对象，分析其血培养阳性报警时间对鉴别临床病原菌的应用。结果：7226份血培养标本检测阳性率为5.83%(421/7226)，在421份血培养阳性瓶中，同时为阳性标本的厌氧瓶与需氧瓶共377份(89.55%)，仅报阳性的厌氧瓶为21份(4.99%)，仅报阳性的需氧瓶为23份(5.46%)。421份报阳性瓶中，共检出菌株205株，病原菌主要以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌及阴沟肠杆菌为主；阳性报警时间平均为(24.53±2.47)h。而需氧瓶与厌氧瓶的平均阳性报警时间分别为(18.60±1.29)、(17.30±1.31)h，两者比较差异无统计学意义(P>0.05)，各病原菌以及污染菌的平均阳性报警时间比较，差异有统计学意义(P<0.05)。结论：血培养阳性报警时间有助于初步鉴别临床病原菌及污染菌，为临床明确诊断提早使用抗生素提供实验室依据。
【关键词】 血培养； 阳性报警时间； 病原菌鉴别； 临床意义
Significance of Time to Positivity of Blood Culture for Clinical Pathogenic Bacteria Identification/SU Jun-mei.//Medical Innovation of China，2017，14(30)：121-124
【Abstract】 Objective：To study and analyze the significance of time to positivity of blood culture for clinical pathogenic bacteria identification.Method：The blood culture specimens of pathogenic microorganisms from fever patients in our hospital from February 2016 to February 2017 were selected as the research objects，the time to positivity of blood culture and its application in clinical pathogenic bacteria identification were analyzed.Result：The positive rate of 7226 blood culture specimens was 5.83%(421/7226)，there were 377 bottles(89.55%) of anaerobic and aerobic bottles positive samples in 421 blood culture positive bottles，only 21(4.99%) of positive anaerobic bottles were reported，only 23(5.46%) of positive aerobic bottles were reported.205 strains were detected in 421 positive bottles.The main pathogenic bacteria were escherichia coli，pseudomonas aeruginosa，klebsiella pneumoniae，staphylococcus aureus and enterobacter cloacae，the average time to positivity was(24.53±2.47)h.the average time to positivity of aerobic bottles and anaerobic bottles was(18.60±1.29) and(17.30±1.31)h respectively，the difference was not statistically significant(P>0.05).The average time to positivity of pathogenic bacteria and contaminated bacteria were compared，the difference was statistically significant(P<0.05).Conclusion：The blood culture time to positivity is helpful for the clinical pathogenic bacteria identification.It would provided evidence of laboratory for the diagnosis and early use of antibiotics for patients.
【Key words】 Blood culture； Time to positivity； Pathogenic bacteria identification； Clinical significance
First-author’s address：Yunfu People’s Hospital，Yunfu 527300，China
doi：10.3969/j.issn.1674-4985.2017.30.036
目前在對血流感染进行临床诊断以及确诊的过程中，血培养是最主要的手段，然而临床工作中血培养标本存在一定的污染率，对判定血流感染存在一定的困难，容易误导临床。然而菌血症的病情复杂严重，早诊断有利于临床合理使用抗生素。因此，判断血培养阳性菌株是病原菌或污染菌显得尤其重要。血培养菌株的阳性报警时间(Time-to-positivity，TTP)是较具临床价值和意义的指标，同时也是血流感染诊断的参考标准，因此也逐渐成为了病情监测以及血流感染诊断的关键手段[1-3]。研究表明，根据全自动血培养仪的报警机制、不同病原菌的生长特点以及观察其TTP值可对临床病原菌的种类进行鉴别[4-5]。因此本文针对血培养阳性报警时间对临床病原菌鉴别的意义进行了研究与分析，现报道如下。, http://www.100md.com(苏俊梅)
2月-2017年2月本院发热患者送检病原微生物室的血培养标本为研究对象，分析其血培养阳性报警时间对鉴别临床病原菌的应用。结果：7226份血培养标本检测阳性率为5.83%(421/7226)，在421份血培养阳性瓶中，同时为阳性标本的厌氧瓶与需氧瓶共377份(89.55%)，仅报阳性的厌氧瓶为21份(4.99%)，仅报阳性的需氧瓶为23份(5.46%)。421份报阳性瓶中，共检出菌株205株，病原菌主要以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌及阴沟肠杆菌为主；阳性报警时间平均为(24.53±2.47)h。而需氧瓶与厌氧瓶的平均阳性报警时间分别为(18.60±1.29)、(17.30±1.31)h，两者比较差异无统计学意义(P>0.05)，各病原菌以及污染菌的平均阳性报警时间比较，差异有统计学意义(P<0.05)。结论：血培养阳性报警时间有助于初步鉴别临床病原菌及污染菌，为临床明确诊断提早使用抗生素提供实验室依据。
【关键词】 血培养； 阳性报警时间； 病原菌鉴别； 临床意义
Significance of Time to Positivity of Blood Culture for Clinical Pathogenic Bacteria Identification/SU Jun-mei.//Medical Innovation of China，2017，14(30)：121-124
【Abstract】 Objective：To study and analyze the significance of time to positivity of blood culture for clinical pathogenic bacteria identification.Method：The blood culture specimens of pathogenic microorganisms from fever patients in our hospital from February 2016 to February 2017 were selected as the research objects，the time to positivity of blood culture and its application in clinical pathogenic bacteria identification were analyzed.Result：The positive rate of 7226 blood culture specimens was 5.83%(421/7226)，there were 377 bottles(89.55%) of anaerobic and aerobic bottles positive samples in 421 blood culture positive bottles，only 21(4.99%) of positive anaerobic bottles were reported，only 23(5.46%) of positive aerobic bottles were reported.205 strains were detected in 421 positive bottles.The main pathogenic bacteria were escherichia coli，pseudomonas aeruginosa，klebsiella pneumoniae，staphylococcus aureus and enterobacter cloacae，the average time to positivity was(24.53±2.47)h.the average time to positivity of aerobic bottles and anaerobic bottles was(18.60±1.29) and(17.30±1.31)h respectively，the difference was not statistically significant(P>0.05).The average time to positivity of pathogenic bacteria and contaminated bacteria were compared，the difference was statistically significant(P<0.05).Conclusion：The blood culture time to positivity is helpful for the clinical pathogenic bacteria identification.It would provided evidence of laboratory for the diagnosis and early use of antibiotics for patients.
【Key words】 Blood culture； Time to positivity； Pathogenic bacteria identification； Clinical significance
First-author’s address：Yunfu People’s Hospital，Yunfu 527300，China
doi：10.3969/j.issn.1674-4985.2017.30.036
目前在對血流感染进行临床诊断以及确诊的过程中，血培养是最主要的手段，然而临床工作中血培养标本存在一定的污染率，对判定血流感染存在一定的困难，容易误导临床。然而菌血症的病情复杂严重，早诊断有利于临床合理使用抗生素。因此，判断血培养阳性菌株是病原菌或污染菌显得尤其重要。血培养菌株的阳性报警时间(Time-to-positivity，TTP)是较具临床价值和意义的指标，同时也是血流感染诊断的参考标准，因此也逐渐成为了病情监测以及血流感染诊断的关键手段[1-3]。研究表明，根据全自动血培养仪的报警机制、不同病原菌的生长特点以及观察其TTP值可对临床病原菌的种类进行鉴别[4-5]。因此本文针对血培养阳性报警时间对临床病原菌鉴别的意义进行了研究与分析，现报道如下。, http://www.100md.com(苏俊梅)