- 期刊
探討BAP/Chromogenic Agar於臨床用藥病人尿液培養之成效
Evaluation for the Performance of Using BAP/chromogenic Agar to Culture Urine from Antimicrobics-treatment Patients
摘要
抗微生物劑的使用情形常連帶影響著菌尿症患者的尿液培養結果。為探討此現象，本研究收集387個臨床檢體利用Blood Agar Plate（BAP）搭配產色素培養基［CHROMagar^(TM) Orientation（CO, Becton Dickinson,Sparks, Md., U.S.A.）或Brilliance UTI Clarity Agar （UTI, Oxoid, U.K.）］，以及搭配檢驗室常使用的EosinMethylene Blue Agar（EMB），評估培養基種類對用藥病人尿液培養之成效（包括菌種分離率、含藥尿液對分離菌之影響、偵測速度及花費成本）。結果發現（1）尿中含抗微生物劑與紀錄的符合率為31.0%。（2）分析各個菌種分離率，Escherichia coli 及Enterococcus spp.於BAP/CO及BAP/UTI分離率皆高於BAP/EMB。（3）於含藥尿檢體中，發現Enterococcus spp.、酵母菌、Acinetobacter spp.及Pseudomonas spp.之分離率較高。（4）在報告時效上，約可省下4~24小時。（5）可增加耐藥性菌種如Acinetobacter spp.的分離。在成本方面，以100個檢體計算，若使用傳統生化試驗鑑定菌種，約可節省台幣500元；若使用套組或自動化儀器則可節省約台幣12,200元。因此在抗微生物劑濫用的情況下，產色培養基將可提昇常見致病菌分離率、縮短偵測時間及降低成本，值得微生物檢驗室加以採用。
並列摘要
Urine culture for patients may be affected by the antimicrobial treatment. We evaluated 387 clinical specimens which performance of chromogenic agar in antimicrobic treatment of patients using 3 different combinations of blood agar plate (BAP) pairing with chromogenic agars [CHROMagar orientation (CO), and Brilliance UTI Clarity Agar (UTI)] and BAP with eosin methylene blue agar (EMB). The performance indicators included isolation rate for each isolate, influence of antimicrobial treatment, detection speed and cost. Our findings revealed the following results: (i) The accordance rate of antimicrobial-treating history marked in the requested form and laboratory findings respect to whether antimicrobial-containing in the urine specimen is 31.0%. (ii) The isolation rate of Escherichia coli and Enterococcus spp. isolated in chromogenic agars is higher than that of BAP/ EMB. (iii) The isolation rate of Enterococcus spp, yeasts, Acinetobacter spp. and Pseudomonas spp. is higher in antimicr obics-containing urine specimens. (iv)The turn-around-time for laboratory reports can be shortened by 4~24 hours. (v) Laboratory that employs conventional identification method can incur costs of NTD $500 per 100 specimens, and incur costs of NTD $12,200 per 100 specimens by employing identification kits or automation identification systems. Based on these findings, we conclude that chromogenic agars may be suitable for the hospital laboratories to perform urine cultures (particularly those in the antimicrobics-abused areas).