CMP^TM GBS鹼體運送館配合GBS carrot agar的一種可提升產前檢查B群鏈球菌的分離率及效率

Combining the CMPTM GBS TranSwab with Subculture on GBS Carrot Agar to Increase the Laboratory Efficacy and the Isolation Rate of Group B Streptococcus in Preterm Pregnant Women

蔡文城(When-Cherng Tsai) ； 蔡偉勳(Wei-Shiun Tsai) ； 呂旭峯(Hsu-Feng Lu) ； 陳詩涵(Se-Han Chen) ； 吳佩真(Pei-Chen Wu) ； 韓之詅(Chi-Liing Han) ； 王彥博(Yen-Po Wang) ； 李秀霞(Hsiu-Hsia Li)

《檢驗及品保雜誌》 4卷2期 (2015/05) Pp. 51-57

https://doi.org/10.6573/JTQA.201505_4(2).01

摘要

一般檢驗室根據行政院衛生福利部國民健康署公告之「B 群鏈球菌（Group B Streptococcus, GBS, Streptococcus agalactiae, 無乳鏈球菌, 乙型鏈球菌）標準作業流程」檢測產前檢查檢體的GBS 分離率約17~20%左右。為了提升GBS分離率及檢驗效率，本實驗室在同時期比較使用CMP^TM GBS檢體運送管(CMP TM GBS TranSwab)（546 個檢體），與嗜氧檢體運送管採檢後接種Lim broth（67 個檢體）的方式評估產前GBS的分離率。檢驗室於收到CMP^TM GBS檢體運送管時，在放入35℃培養箱前以及培養18~24 小時後皆進行移種GBS carrot agar，而嗜氧檢體運送管於接種Lim broth 前及培養18~24 小時後，則皆移種BAP(blood agar plate)，然後將二種檢驗方式的培養結果進行分析比較。結果指出：使用CMP^TM GBS檢體運送管培養前的移種，GBS的分離率為23.8%，培養隔日的移種可增加分離率0.7%，總分離率達24.5%，而使用嗜氧檢體運送管接種Lim broth前移種，GBS分離率為7.5%，而增菌後的移種可增加分離率9.0%，總分離率為16.5%。總之，使用CMP^TM GBS 檢體運送管的檢測流程比使用嗜氧檢體運送管再接種Lim broth 的GBS 分離率高8.0%(24.5% vs. 16.5%)；且前者可從GBS carrot agar 生長菌落顏色立即判斷GBS 的存在，不必再操作鑑定試驗而可降低鑑定菌種的人力及物力，提早發出檢驗報告，因此，亦可提升GBS的分離效率，值得產科醫師及臨床檢驗人員的應用。

關鍵字

B 群鏈球菌 ； GBS 分離率 ； CMP^TM GBS 檢體運送管

並列摘要

The standard laboratory procedure of Group B Streptococcus (GBS) promulgated by the Bureau of Health Promotion, Ministry of Health and Welfare, Executive Yuan, Taiwan, suggests that the aerobic swab-specimens from preterm pregnant women received by a laboratory should be inoculated blood agar plate (BAP) after being inoculated into enrichment medium, Lim broth or carrot broth. Carrot broth can also be used as a differential medium for GBS identification based on the production of the carrot color. If the inoculated carrot broth did not show carrotcolor change after one-day incubation, then conducted subculture from incubated enrichment medium to BAP. Generally, following the above procedure will result in an isolation rate of around 20%. In this study, to increase the isolation rate of GBS, we processed the preterm test by using a transport system, CMPTM GBS TranSwab, and subsequently inoculating one GBS carrot agar (CMP, New Taipei City, Taiwan). The results obtained will be used to compare with what obtained from the official method stated as above. We totally evaluated 546 specimens from preterm pregnant women. Compare the results of “combining GBS TranSwab and GBS carrot agar subculture” with what of “combining aerobic TranSwab with Lim broth enrichment and BAP subculture”. Results indicated that the GBS isolation rate of former combination were 8% higher than what of the latter combination (24.5% vs. 16.5%). In addition to this advantage by employing the former combination, lab workers can identify the presence of GBS immediately based on visual observation the carrotcolor colonies appeared on GBS carrot agar. Therefore, no additional identification tests need be conducted. Based on the above finding, we can conclude that the adaption of both GBS TranSwab and GBS carrot agar in a laboratory can increase the isolation rate of GBS, speed up the identification of GBS, decrease costs in terms of both man-power and test materials, and shorten the time for reporting laboratory results. Therefore, the use of GBS TranSwab and GBS carrot agar should be worth implementing in clinical laboratories.

並列關鍵字

GBS TranSwab ； GBS carrot agar ； GBS isolation rate ； Lim broth enrichment