四种清热解毒中药注射液对血培养产KPC酶肺炎克雷伯菌感染的干扰实验及应对策略

The interference experiment and countermeasures of four kinds of heat-clearing and detoxifying traditional Chinese medicine injection for klebsiella pneumoniae carpenemase produced by blood culture

目的研究痰热清、清开灵、热毒宁及喜炎平中药注射液对体外血培养产KPC酶肺炎克雷伯菌(KPC酶)感染时产生药物干扰后,血培养阳性报警时间差异以及应对药物干扰策略。方法分别将痰热清、清开灵、热毒宁及喜炎平注射液建立实验组,按照不同浓度注入到血培养瓶内,观察和比较实验组与对照组血培养阳性报警时间。结果痰热清注射液100%、50%浓度实验组与对照组比较,产KPC酶肺炎克雷伯菌阳性报警时间延长为41.9%、25.6%;清开灵注射液100%、50%浓度实验组与对照组比较,阳性报警时间延长为9.3%、4.7%;热毒宁注射液100%、50%、25%、12.5%浓度实验组与对照组比较,阳性报警时间延长为62.8%、51.1%、32.6%、27.9%;喜炎平注射液100%、50%、25%、12.5%浓度实验组与对照组比较,阳性报警时间延长均为0%。结论痰热清、清开灵和热毒宁注射液对血培养产KPC酶肺炎克雷伯菌感染报警时间延长,喜炎平注射液不产生干扰;血培养阳性报警延长时间结果热毒宁>痰热清>清开灵>喜炎平;送检血培养避免药物干扰,并且建立应对策略。

Objective To study the differences in the alarm time of positive blood culture and the countermeasures against drug interference caused by the infection of Klebsiella pneumoniae carpenemase(KPC enzyme)by Tanreqing,Qingkailing,Reduning and Xiyanping injections.Methods The experimental group was established by Tanreqing,Qingkailing,Reduning and Xiyanping injections respectively,which were injected into the blood culture bottle according to different concentrations.The alarm time of positive blood culture of the experimental group and the control group was observed and compared.Results Compared with the control group,the alarm time of KPC-producing Klebsiella pneumoniae in the experimental group with 100%and 50%concentrations of Tanreqing injection was extended to 41.9%and 25.6%,respectively.Compared with the control group,the alarm time of positive was respectively extended to 9.3%and 4.7%in the experimental group with 100%and 50%concentrations of Qingkailing injections.Compared with the control group,the alarm time of positive was respectively extended to 62.8%,51.1%,32.6%and 27.9%in the experimental group with 100%,50%,25%and 12.5%concentrations of Reduning.Compared with the control group,the alarm time of positive was all extended to 0%in the experimental group with 100%,50%,25%and 12.5%concentrations of Xiyanping injection.Conclusion Yanreqing,Qingkailing and Reduning injections prolong the alarm time of KPC enzyme Klebsiella pneumoniae infection in blood culture and Xiyanping injection has no interference.Extended alarm time of positive blood culture of Reduning is the longest,followed by Tanreqing,Qingkailing and Xiyanping.The submitted blood culture should avoid drug interference and it is supposed to establish coping strategies.