摘要
目的分析本院检验科血培养仪检测阳性标本报警时间,寻找缩短血培养阴性报告时间的方法。方法收集长治市人民医院2018年6月—2019年1月住院时间为8个月患者的4 318份血液培养标本,采用法国梅里埃Bact/Alert 3D 60全自动血培养仪培养,统计阳性标本,记录所有阳性标本的阳性报警时间(TTP)并计算中位值,统计病原菌的种类及构成比。结果血培养阳性标本共475份,阳性率为11.0%;其中革兰阳性(G+)菌112份(占23.6%),革兰阴性(G-)菌361份(占76.0%),真菌2份(占0.4%)。G+菌中,葡萄球菌89份(18.7%)〔包括凝固酶阳性葡萄球菌51份(10.7%)、凝固酶阴性葡萄球菌38份(8.0%)〕,中位时间36.00 h;肠球菌17份(3.6%),中位时间14.40 h;链球菌6份(1.3%),中位时间36.48 h。G-菌中,大肠杆菌163份(34.3%),中位时间11.04 h;肺炎克雷伯菌91份(19.2%),中位时间11.43 h;非发酵菌99份(20.8%),包括铜绿假单胞菌67份(14.1%)、鲍曼不动杆菌32份(6.7%),中位时间17.04 h;其他G-菌8份(1.7%),中位时间26.32 h。真菌2份(0.4%),中位时间55.20 h。TTP最早为0.4 h,最迟为86.4 h,97.68%病原菌在72 h内阳性报警,100%病原菌在96 h内阳性报警。结论血培养阳性病原菌TTP由快到慢依次为大肠杆菌、肺炎克雷伯菌、肠球菌、非发酵菌、葡萄球菌、链球菌、真菌。所有病原菌均在4 d内报阳,因此考虑可将血培养阴性报告时间缩短为5 d,以节约医疗成本。
Objective To analyze the alarm time of positive blood culture samples detected by French Meriere Bact/Alert 3D 60 blood culture analyzer, and to explore the method of shortening the reporting time of negative blood culture. Methods The blood culture specimens of patients hospitalized for 8 months from June 2018 to January 2019 in Changzhi People's Hospital were collected and cultured in French Meriere Bact/Alert 3D 60 automatic blood culture analyzer. The positive specimens were counted, the alarm times of all positive specimens (TTP) were recorded, their median values were calculated, and the species of pathogenic bacteria and their percentages of compositions were counted. Results There were 475 blood culture positive specimens, the positive rate being 11.0%, of which 112 were Gram positive (G^+) bacteria (23.6%), 361 Gram negative (G^-) bacteria (76.0%) and 2 fungi (0.4%). Among G^+ bacteria, 89 (18.7%) wereStaphylococcus[including 51 (10.7%) coagulase positiveStaphylococcus and 38 (8%) coagulase negativeStaphylococcus], with a median time of 36.00 hours;17 (3.6%) wereEnterococcus, with a median time of 14.40 hours;6 (1.3%) were Streptococcus, with a median time of 36.48 hours. Among Gbacteria, 163 (34.3%) were Escherichia coli, with a median time of 11.04 hours;91 (19.2%) were Klebsiella pneumoniae, with a median time of 11.43 hours;99 (20.8%) were non-fermentative bacteria [including 67 (14.1%) Pseudomonas aeruginosa and 32 (6.7%) Acinetobacter baumannii], with a median time of 17.04 hours;8 (1.7%) were other G^- bacteria, with a median time of 26.32 h. Fungi were found in 2 cases (0.4%) with an average median time of 55.20 hours. The earliest positive alarm time was 0.4 hours, the latest was 86.4 hours, 97.68% of pathogenic bacteria positive were reported within 72 hours, and 100% of them, reported within 96 hours. Conclusions The alarm times of positive pathogens in blood culture sequentially from quick to slow were Escherichia coli, Klebsiella pneumoniae,Enterococcus, non-fermenting bacteria,Staphylococcus,Streptococcusand fungi. All positive pathogenic bacteria were reported within 4 days, so that the negative reporting time of blood culture could be shortened to 5 days to save medical costs.
作者
孙静
Sun Jing(Department of Laboratory,the People's Hospital of Changzhi City,Changzhi 046000,Shanxi,China)
出处
《实用检验医师杂志》
2019年第1期52-54,共3页
Chinese Journal of Clinical Pathologist
关键词
血培养
病原菌
阳性
报警时间
Blood culture
Pathogenic bacteria
Positive
Alarm time
