血培养阳性标本直接细菌鉴定和药敏的临床应用.docVIP

血培养阳性标本直接细菌鉴定和药敏的临床应用 张芸燕 徐军* (苏州市中医医院检验科，江苏苏州215000) 摘要：目的 探讨血培养阳性标本的细菌快速鉴定和药敏实验，与常规法（转种后取得的纯菌落鉴定及药敏试验）的符合率。方法 将一定量血培养阳性标本的培养液至分离胶的试管中，离心后取分离胶上层含菌液体，采用全自动细菌鉴定仪直接进行细菌鉴定和药敏敏感试验。并与转种后取得的纯菌落上机鉴定及药敏结果进行比较。结果 76例血培养阳性标本直接上机与转种菌落上机鉴定结果符合率达94.7%以上；药敏试验结果符合率95%，直接法比常规法提前近24h。结论 血培养阳性标本进行直接鉴定及药敏试验可行，可大幅度缩短时间，与常规法的实验结果符合率高。 关键词 血培养；阳性；自动分析；直接药敏 Clinical application of positive specimens directly bacterial identification and susceptibility of blood culture ZHANG Yunyan（Department of Clinical Laboratory, Suzhou Traditional Chinese Medical Hospital, Jiangsu Suzhou,China,215000） Abstract: Objective To discuss the clinical value of the automated microbial identification system in direct identification of blood culture positive samples and drug susceptibility test ,as well as the coincidence rate between the direct method and the routine one. Methods To mix the positive blood culture solution with the separation gel tube,and then inoculate on the special identify panel to perform bacterium identification and antibiotic susceptibility test directly. At last, to contrast the result to the regular one.Results The coincidence rate between 76 samples of the positive blood culture substance on the system directly and the regular method was more than 94.7%.And the coincidence rate of antibiotic susceptibility test between the direct method and the regular one was more than 95%.And the results of the direct method could be acquired 24h earlier than those of the regular one. Conclusion The direct antibiotic susceptibility test method reduces the testing time,and get more time for bacteria treating.Meanwhile,the coincidence rate between the regular method and the direct one is high. Key words: Blood culture; Positive;Autoanalysis;Direct susceptibility testing 细菌血症或真菌血症相关的感染为血流感染[1]。血流感染是临床上十分常见，也是重症患者最主要的死亡原因之一。在美国，血流感染每年约25万例，住院患者中，血流感染从1980年的6.7%上升到1992年的18.4%[2],病死率为27%~28%[3]，美国一项研究结果显示，血流感染病死率高，且延长住院时间，增加住院费用，危害严重。尽管医学水平在不断发展，但诊断血流感染最好的方法仍是进行血培养。快速诊断是控制感染、降低死亡率的关键。临床上使用全自动血培养仪，提