643瓶阳性血培养的病原菌分布和双套培养法的价值分析

The distribution of pathogens detected in 643 bottles of positive blood culture and the value of double blood culture

目的:了解阳性血培养的病原菌分布,探讨送检2套血培养对病原菌检出率和排除污染率的价值。方法:采用全自动血培养仪对某医院2017年-2019年送检的3798瓶血标本进行培养,对643瓶阳性的标本进行统计分析。结果:三年共检出阳性标本643瓶405株细菌,前四位分别为凝固酶阴性葡萄球菌、大肠埃希菌、金黄色葡萄球菌和肺炎克雷伯菌,检出率分别为24.7%、22.2%、9.6%和8.1%;共送检2套血培养1884瓶,396瓶阳性,检出率为21.0%,2套血培养的细菌分离率明显高于单份血培养的分离率,两者差异有统计学意义(P<0.05);送检的双份血培养均阳性和送检的双份血培养中单瓶阳性的细菌分布也有明显的差异。结论:双套血培养能够明显提高阳性率和降低污染率,所以临床应常规至少送检2套血培养。

Objective:To understand the distribution of pathogenic bacteria in our hospital's positive blood culture and the effect of double sets of blood culture on the distribution and detection rate of pathogenic bacteria.Methods:A total of 3798 bottles of blood culture were performed from 2017 to 2019 using automated detection system,and the pathogens of positive blood culture were analyzed.Results:From them 643 bottles of positive blood cultures occurred during the study period.The most common stains were coag ulase-nagetive staphylococcus(24.7%),followed by Escherichia coli(22.2%),Staphylococcus aureus(9.6%)and Klebsiella pneumoniae(8.1%).During the study period,a total of 1884 bottles of double sets blood cultures were submitted for detection,and 396 bottles were positive.The detection rate was 21.0%.The detection rate of pathogens in double sets blood cultures was significantly higher than that in single set blood cultures.The difference was statistically significant(P<0.05);there was also a significant difference in the distribution of pathogens that were positive in double sets blood cultures and single set bottle positive in double sets blood cultures.Conclusion:Since double sets blood culture can significantly increase the positive rate and reduce the contamination rate,it should be routinely submitted at least 2 sets blood cultures.