BD BACTEC 9120血培养仪联合血清降钙素原在血流感染诊断中的应用

Research on BD BA CTEC 9120 blood culture instrument combined with serum PCT in diagnosis of bloodstream infections

目的:比较革兰阳性(G+)菌和革兰阴性(G-)菌血流感染(BSI)的血清降钙素原(PCT)水平,探讨血培养与PCT联合检测在临床诊断中的意义。方法:采用BD BACTEC9120型全自动血培养仪对199例住院发热患者的血液标本进行细菌培养,同时检测PCT水平,比较PCT浓度水平在血培养阳性与阴性之间以及革兰阳性细菌与阴性细菌之间的差异。结果:1筛选出检测PCT的99例血培养阳性标本中分别检出18种细菌,其中表皮葡萄球菌构成比最大(占17.2%);其余依次为大肠埃希菌(占16.2%)和鲍曼不动杆菌(占10.1%);2血培养阳性与血培养阴性标本PCT结果比较差异有统计学意义;3血培养革兰阳性菌与革兰阴性菌PCT结果比较无明显差异,但如果将革兰阳性菌组金黄色葡萄球菌的结果去除,再与革兰阴性菌相比差异有统计学意义。结论:PCT对革兰阴性菌与革兰阳性菌感染有一定的判别作用,配合血培养检测能辅助临床的快速诊断,提示临床初步抗生素的使用方向,减少用药的盲目性和耐药菌株的出现。

Objective： Compare gram-positive （G＋）bacteria and gram-negative bacteria （G-） bloodstream infections of serum procalcitonin（PCT） original level, to explore the clinical significance of blood culture and PCT joint detection. Methods： One hundred and ninty nine cases were selected, by using BD BACTEC 9120 type automatic blood culture instrument to detect the bacterial culture and at the same time the PCT results, comparative PCT concentration in blood cultures between positive and negative results and gram-positive bacteria and gram-negative bacteria. Results：（1）Screening detection of PCT were detected in 99 cases of specimens of blood culture positive for 18 species of bacteria including staphylococcus epidermis form than most, by 17.2%;The second is the e. coli were 16.2%and 10.1%acinetobacter baumannii. （2）blood culture positive for compared with the blood culture negative specimens of PCT difference was statistically significant. （3）blood culture gram-positive bacteria and gram-negative bacteria PCT results compare difference was not statistically significant, But if the group of gram-positive bacteria staphylococcus aureus results to remove from the group, compared with gram-negative bacteria difference was statistically significant. Conclusion：PCT of gram negative bacteria and gram positive bacterial infection has certain diagnostic role, with rapid diagnosis of clinical blood culture detection can be assisted, prompt clinical initial direction of the use of antibiotics, reduce blindness, reduce the emergence of resistant strains.