非苛养菌药物敏感试验孵育不同时间后的结果分析研究

Non-fastidious Bacteria＇s Antimicrobial Susceptibility Comparison with Different Incubation Times

目的探讨琼脂扩散法细菌药物敏感实验结果的最快报告时间，为危重感染患者抢救治疗赢得时机；避免临床盲目用药，减轻患者的经济损失和身体损害。方法纸片琼脂扩散法：严格按照文献操作，每株细菌做6个（种）药敏纸片测试，根据抗菌药物敏感性试验执行标准（CLSI），不同细菌挑选不同的抗菌药物纸片，上午9～10时划线接种MH培养基及贴药敏纸片，置于35～37℃温箱孵育，当日下午16～17时（7～8h后）测量一次押菌环并记录。而后继续孵育于温箱，次日8时（22～23h后）再次测量抑菌环，将其两次抑菌环根据抗菌药物敏感性试验执行标准（CLSI）记录结果（S，I，R），把7～8h后结果敏感（S）者为敏感组，不敏感（I，R）者为不敏感组，22～23h后敏感组与不敏感组分别记录相同的争不相同的，然后将其两组相同的扣不相同的资料进行统计学比较分析。结果非苛养细菌（肠杆菌、非发酵菌、葡萄球菌等）100株，600个药敏纸片孵育7～8h后敏感者288个（敏感组），不敏感者312个（不敏感组），孵育22q3h后敏感组仍然敏感的（相同的）279个，不敏感的（不相同的）9个；不敏感组仍然不敏感的（相同的）293个，敏感的（不相同的）19个，其孵育22～23h后敏感组与不敏感组分别相同的扣不相同的经卡方检验差异无统计学意义，Х^2=2．96，P〉0．05。结论非苛养菌药物敏感试验结果报告可适当提前，由原来的18-24h提前到7～8h（次日上午提前到当日下午）报结果，为抢救患者生命赢得时机有着很重要的意义；避免临床盲目用药、减少耐药菌椿的产生，对控制院内感染亦有重要意义。

Objective To study the fastest time of the report about antimicrobial susceptibility test and towin the best op- portunity for emergency treatment of critically ill infected patlents;To avoid clinical drug ill-use and save money for patients and to lighten physical injury of patients. Methods Agar diffuse method was used to operate strictly under the literature. There were 6 different kinds of drug that were experimented on every bacterium. According to the rules of CLSI, chose different kinds of drugs to different bacterium. The bacteria were incubated in MH vessel at 35-37℃. Inhibitory concentration of antimicrobial susceptibility test was measured 7-8 hours and 22-23 hours,respectively. Then registered the results under the standard of CLSI. Separated the result into 3 groups. Signed it S group,I group and R group. Then, compared and analyzed the same and different results. Results After 600 kinds of drug experiment,the S group had 288 member and the R group had 312 member. The results of non-fastidious bacteria＇s （such as Enterobacteriaceae,Nonfer- mentative Bacilli,Staphylococcus and so on） antimicrobial susceptibility test had no significantly differences between 7-8 hours＇ and 22-23 hours＇ （Х^2=2. 96,P〈0. 05）. Conclusion The report time of the antimierobial susceptibility test of non-fastidious bacteria could be moved up to 7-8 hours later. It has great significance to win the best opportunity for emergency treatment of critically ill infected patients. It also can avoid clinical drug ill-use and control infection in hospital.