Predictive value of isolating Pseudomonas aeruginosa from aerobic and anaerobic blood culture bottles
Predictive value of isolating Pseudomonas aeruginosa from aerobic and anaerobic blood culture bottles
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DOI：
10.1099/jmm.0.45727-0
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发表时间：
2004-11-01
影响因子：
3
通讯作者：
Kibbler, CC
中科院分区：
文献类型：
--
作者：
Enoch, DA;Simpson, AJH;Kibbler, CC
当铜绿假单胞菌引起菌血症时，它是一种特别致命的病原体。早期诊断是降低发病率和死亡率的关键。它是一种需氧细菌，许多人认为在菌血症的情况下，它几乎完全是从好氧血培养瓶中分离出来的。这项研究分析了一家机构超过一年的277例革兰氏阴性菌血症病例，以评估这一发现的预测价值。在44例铜绿假单胞菌菌血症中，有39例仅从需氧瓶中分离到该菌，其敏感性为88.6%，特异性为73.8%。然而，对于所有的革兰氏阴性菌血症，在需氧瓶中首先出现革兰氏阴性杆菌的可能性只有39%。反之，首先在厌氧培养瓶中或从两个培养瓶中同时分离出一株革兰阴性杆菌对临床有帮助，其阴性预测值为97.2%(即该菌不是铜绿假单胞菌)。
Pseudomonas aeruginosa is a particularly virulent pathogen when it causes bacteraemia. and early diagnosis is essential to reduce morbidity and mortality. It is an aerobe and is thought by many to be almost exclusively isolated from the aerobic blood culture bottle in cases of bacteraemia. This study analysed 277 Gram-negative bacteraemic episodes over 1 year at a single institution in order to assess the predictive value of this finding. In 39 of 44 episodes of P. aeruginosa bacteraemia, the organism was isolated from the aerobic bottle only, which gave a sensitivity of 88.6% for this 'test' and a specificity of 73.8%. However, for all episodes of Gram-negative bacteraemia, the likelihood of a Gram-negative bacillus occurring in the aerobic bottle first being P. aeruginosa was only 39%. The converse finding of a Gram-negative bacillus isolated first in the anaerobic bottle or from both bottles together was clinically helpful, having a negative predictive value of 97.2% (i.e. that the organism was not P. aeruginosa).