Improved detection of bacterial growth in continuous ambulatory peritoneal dialysis effluent by use of BacT/Alert FAN bottles
Improved detection of bacterial growth in continuous ambulatory peritoneal dialysis effluent by use of BacT/Alert FAN bottles
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DOI：
10.1128/jcm.35.4.862-866.1997
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发表时间：
1997-04-01
影响因子：
9.4
通讯作者：
Harding, GKM
中科院分区：
文献类型：
--
作者：
Alfa, MJ;Degagne, P;Harding, GKM
培养阴性腹膜炎是连续不卧床腹膜透析 (CAPD) 患者的主要并发症，并且阻碍了机体特异性治疗。本研究的目的是比较将 10 ml CAPD 流出液接种到 BacT/Alert 血培养瓶（FAN [挑剔的抗菌剂中和]、BacTAlert 需氧 [BTA] 和 BacT/Alert） 厌氧 [BTAn] 瓶）与我们使用 50 mi 浓缩 CAPD 流出液接种蛋白胨肉汤瓶（ED 瓶）和麦康凯琼脂和血琼脂培养基（BA-MAC）的传统方法相比，在 BacT/Alert 血培养仪中自动监测 FAN、BTA 和 BTAn 瓶，总共研究了 207 种 CAPD 流出液，并在 97 种细菌中进行了检测。 通过至少一种方法检测到，与 BTA 瓶（97 个中的 79 个；81.4%）、BTAn 瓶（97 个中的 78 个；80.4%）和 ED 瓶（97 个中的 88 个；90.7%）相比，检测 CAPD 废水中细菌生长的单一最佳肉汤培养基是 FAN 瓶（97 个废水中的 90 个；92.8%），总共 125 个细菌物种是 任何方法都可检测到，并且大多数 (91.8%) CAPD 流出物感染单一物种，FAN 和 BTAn 瓶的组合检测到所有生物体的 125 种中的 111 种 (88.8%)，而 ED 瓶和 BA-MAC 的组合检测到所有生物体的 125 种中的 107 种 (85.6%)，使用 ED 瓶的传统方法会完全漏掉一种或多种生物体 在 18 份 CAPD 废水中检测到了 BA-MAC。在这 18 种 CAPD 流出物中，有 6 种通过使用 ED 瓶和 BA-MAC 的常规方法显示没有生长。根据我们的数据，最敏感且劳动强度最小的方法是将 10 mi 的 CAPD 流出物直接接种到 FAN 瓶和 BTAn 瓶中，这可以通过 BacT/Alert 血培养仪自动监测。根据腹膜炎的病例定义，使用 FAN 和 BTAn 瓶以及使用 ED 瓶和 BA-MAC 的方法的敏感性和特异性分别为 81.1% 和 98.8%， 分别为 74.5% 和 96.5%。
Culture-negative peritonitis is a major complication for patients on continuous ambulatory peritoneal dialysis (CAPD) and precludes organism-specific therapy, The aim of the present study was to compare inoculation of 10 ml of CAPD effluent into BacT/Alert blood culture bottles (FAN [fastidious antimicrobic neutralizing], BacTAlert aerobic [BTA], and BacT/Alert anaerobic [BTAn] bottles) to our conventional method of using 50 mi of concentrated CAPD effluent to inoculate peptone broth bottles (ED bottles) and MacConkey agar and blood agar medium (BA-MAC), The FAN, BTA, and BTAn bottles were monitored automatically in the BacT/Alert blood culture instrument, A total of 207 CAPD effluents were studied, and in 97 bacteria were detected by at least one method, Compared to BTA bottles (79 of 97; 81.4%), BTAn bottles (78 of 97; 80.4%), and ED bottles (88 of 97; 90.7%), the single best broth medium for detecting bacterial growth in CAPD effluents was the FAN bottle (90 of 97 effluents; 92.8%), A total of 125 bacterial species were detected by any method, and the majority (91.8%) of CAPD effluents were infected with a single species, A combination of FAN and BTAn bottles detected 111 of 125 (88.8%) of all organisms, whereas a combination of ED bottles and BA-MAC detected 107 of 125 (85.6%) of all organisms, One or more organisms that would have been completely missed by the conventional method with ED bottles and BA-MAC were detected in 18 CAPD effluents. Of these 18 CAPD effluents, 6 showed no growth by the conventional method with ED bottles and BA-MAC. On the basis of our data, the most sensitive and least labor intensive method was direct inoculation of 10 mi of CAPD effluent into a FAN bottle and a BTAn bottle, which could be automatically monitored by the BacT/Alert blood culture instrument, On the basis of case definitions for peritonitis, the sensitivities and specificities of the methods with FAN and BTAn bottles and with ED bottles and BA-MAC were 81.1 and 98.8% and 74.5 and 96.5%, respectively.