Comparison of Antimicrobial Susceptibility Testing of Isolates from Blood Cultures by Direct Inoculation Method and PHOENIX

血液感染在醫院常有較高的致死率，以液態培養基培養微生物是目前實驗室標準做法，雖然革蘭氏染色提供治療方向的線索，但在得到鑑定及藥敏結果前的期間卻對病人的生命安全有潛在危險。這研究的目的是爲提供比染色結果及培養結果出現前更多的治療參考。直接瓊脂擴散方法是：將血液檢體直接塗抹在培養皿上以及測量微生物藥敏抑制圈，有兩隻菌以上的檢體不在此實驗範圍內。十個月期間總共有815株菌分離出，包括大腸桿菌(57%)、克列博氏菌(20.16%)、陰溝腸桿菌(6%)、綠膿桿菌(9.1%)、嗜麥芽寡養單胞菌(3.1%)、鮑氏不動桿菌(3.1%)被分離出來，並以BD的臨床自動鑑定儀(phoenix)的結果爲對照。所得實驗結果和自動化結果相近(99%~100%)，這對於臨床治療的思考以及病人安全照顧提供一個方向。

關鍵字

血液感染；菌血症；藥敏

並列摘要

Background: Bloodstream infection (BSI) is an important cause of serious morbidity and mortality for hospitalized patients. Empirically Gram stain of bacteria gives the first clue for the etiology of infection and medical treatment. But the delayed treatment on 1 or 2 days after phenotypic identification and drug susceptibility testing may cause potential danger to patients. Rapid drug susceptibility testing can provide earlier information to guide treatment and in less time than bacterial culture and sensitivity testing, for antibiotics therapy. Methods: In this study, we excluded samples of polymicrobial bacteremia. We collected isolates from 815 infection episodes caused by Escherichia coli (57%), Klebsiella pneumoniae (20.16%), Enterobacter cloacae (6%), Ps. aeruginosa (9.1%), Stenotrophomonas maltophilia (3.1%), and Acinetobacter baumannii (3.1%) in a 10-month period. We identified those bacteria with direct susceptibility test with the use of Phoenix100 (BD) during a 10-month period. Results: The results of direct susceptibility were concordant (99%-100%) with those obtained from Phoenix100. Conclusion: These results have the potential to guide clinicians to initiate an early antimicrobial therapy in febrile patients with sepsis shock.

並列關鍵字

bloodstream infection ； bacteremia ； direct susceptibility test

國際替代計量

Comparison of Antimicrobial Susceptibility Testing of Isolates from Blood Cultures by Direct Inoculation Method and PHOENIX

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