临床医生如何解读培养结果

How to interpret the results of bacteriologic culture

对于严重感染患者,培养结果对于正确实施抗生素治疗策略非常重要。应用有创机械通气的患者下呼吸道存在细菌定植,从而影响了气管内吸取物培养的敏感性和特异性。培养结果阳性并不能可靠鉴别致病菌和定植菌,相反,培养结果阴性有助于排除感染和(或)致病菌。同样,血培养阳性结果也受到细菌污染的影响。临床医生可以根据分离细菌种类,并结合临床表现鉴别致病菌和污染菌。

Correct interpretation of bacteriologic culture resuhs is crucial for the antibiotic treatment of severe sepsis or septic shock. In patients with mechanical ventilation, colonization at lower respiratory tract is very common. This might have a significant im- pact on the sensitivity and specificity of non-quantitative culture of endotracheal aspirate. As a result, the positive results of endotracheal aspirate may not be used to differentiate pathogens and colonizers. On the contrary, a negative culture might help to rule out infection and/or a specific bacterium as the cause of infection. Moreover, positive cultures of blood culture may be resulted from contamination. Clinicians could differentiate pathogens and contaminants based on bacterial identification as well as clinical manifestations.