血培养瓶法在无菌体液病原菌培养中的应用

Application of blood culture bottle method for pathogenic bacteria culture with aseptic humoral

目的探讨血培养瓶法在无菌体液病原菌培养中的应用。方法收集2013年3～9月四川省人民医院共321份无菌体液标本,通过双瓶血培养瓶法和直接接种法培养分离病原菌,通过与传统的直接接种法比较对其进行评价。结果 321份标本中,通过血培养瓶法108份标本培养出细菌,阳性率为33.6%;直接接种法55份标本培养出细菌,阳性率为17.1%,差异有统计学意义(P<0.01)。血培养增菌后80%细菌在24～48h内检出,而直接接种法90%细菌在24h检出,检出时间直接接种法更具优势。两种方法检出细菌前3位均为屎肠球菌、大肠埃希菌和肺炎克雷伯菌,而凝固酶阴性葡萄球菌、草绿色链球菌等在血培养法中检出率明显高于直接法。血培养瓶法的敏感性为89.7%,阴性符合率为95.3%,直接接种法分别为43.2%和76.3%,而阳性符合率直接法略高于血培养瓶法。导致培养结果假阴性的细菌主要为凝固酶阴性葡萄球菌、棒状杆菌和微球菌。结论血培养法的敏感性明显高于直接接种法,可提高病原菌检出率,与直接接种法同时培养可缩短检出时间并防止漏检,特别是对链球菌群、厌氧菌和真菌的检出具有显著优势,但需注意严格无菌操作,减少污染环节。

Objective To assess the application of blood culture bottle method for pathogenic bacteria culture with aseptic humoral .Methods A total of 321 aseptic humoral specimens were collected in hospital from March to September in 2013 .All specimens were detected by double blood culture bottles method and direct inoculation meth-od .The comparison between the two methods was analyzed .Results The positive rate of the blood culture bottle method was 33 .6% （108/321） ,while 17 .1% （55/321） as the direct inoculation method ,and the difference between the two methodsv was statistically significant （P〈 0 .01） .For the blood culture bottle method ,80% bacteria were checked out within 24 to 48 hours ;for the direct inoculation method ,90% bacteria were checked out within 24 h .The top three detected bacteria were Enterococcus faecium ,Escherichia coli and Klebsiella pneumoniae for both methods . However ,for the Coagulase negative staphylococcus ,Streptococcus viridans ,Rod bacillus ,Micrococcus ,Anaerobic bacteria and fungi ,the positive rates of the blood culture bottle method were significant higher than that of the direct inoculation method .The sensitivity and negative coincidence rate of blood culture bottle method were 89 .7% and 95 .3% respectively ,while 43 .2% and 76 .3% as the direct inoculation method .The positive coincidence rate of the direct inoculation method was slightly higher than that of the blood culture bottle method .Coagulase negative staphy-lococcus ,corynebacterium and micrococcus were the mainly false negative bacteria .Conclusion The sensitivity of the blood culture bottle enrichment method was higher than that of the direct inoculation method for pathogenic bacteria culture with aseptic humoral ,it could increase the positive rate of pathogen detection ,especially for the streptococcus group ,anaerobic bacteria and fungi .