常見生殖道定植菌在CMP^(TM) GBS運送增菌培養管中的消長評估

Evaluation of Growth of Commonly Encountered Colonizing Bacteria of the Genitourinary Tract in the CMP^(TM) GBS TransCultSwab

黃玉霞(Yuxia Huang) ； 蔡文城(Wen-cherng Tsai)

《檢驗及品保雜誌》 6卷4期 (2017/11) Pp. 172-177

https://doi.org/10.6573/JTQA.201711_6(4).02

摘要

CMP^(TM)GBS運送增菌培養管(CMP^(TM) GBS TransCultSwab)系針對B群鏈球菌（Group B Streptococcus，GBS，Streptococcus agalactiae，B 族鏈球菌）檢驗檢體的採檢、輸送、增菌與輔助鑑別的創新裝置，以此裝置中的棉拭從懷孕35-37周孕婦的生殖道及／或直腸取得檢體後，插入裝置中含有特殊成分運送培養基的塑膠管，經35℃培養箱培養或室溫放置5小時(h)後，即可移種至適當的培養基，如GBS carrot agar//detection agar、血平板(BAP)、CNA、PEA或CHROMagar Strept. B。由於生殖道及／或直腸棉拭檢體常含有定植（棲息、常在）該部位的各種微生物，有關定植菌在CMP^(TM) GBS TransCultSwab 初期的消長狀況尚無相關調查，因此本研究以五種常見的生殖道及/或直腸的定植菌進行評估，測試菌包括GBS、糞腸球菌(Enterococcus faecalis)、大腸桿菌(Escherichia coli)、金黃色葡萄球菌(Staphylococcus aureus)與棒狀桿菌(Corynebacterium sp.)五種菌。GBS 與糞腸球菌分別接種棉拭約103 CFU，而大腸桿菌、金黃色葡萄球菌與棒狀桿菌分別接種棉拭約106 CFU，再插入CMP^(TM) GBS TransCultSwab，然後置入35 ℃的一般培養箱，分別於0、1、2、3、4與5小時進行菌落總數計數(total viable counts)，結果指出隨著培養時間的延長，GBS與糞腸球菌的菌量隨著增加，培養5小時後，菌量分別增加約154倍及86倍；相反地，大腸桿菌菌量則降低約36倍。至於金黃色葡萄球菌與棒狀桿菌的菌數則無顯著變化。基於上述的發現，吾等認為CMP^(TM) GBS TransCultSwab 可即時讓GBS增菌，降低其它定植菌的菌量，從而提高GBS分離率，值得臨床醫師及檢驗人員的應用。

關鍵字

B群鏈球菌 ； CMP^(TM) GBS 運送增菌培養管 ； 定植菌的消長

並列摘要

The CMP^(TM) GBS TransCultSwab is an innovative device used for specimen collection and transport, as well as for the enrichment and preliminary detection of group B Streptococcus (GBS, Streptococcus agalactiae). The swab contained in the device is applied to collect genitourinary or rectal specimens between weeks of 35 and 37 of pregnancy, after which it is inserted into a plastic tube containing the special ingredients of a GBS enrichment medium and then transported to the laboratory. After 5 hours of incubation either at 35°C or room temperature, the swab is then inoculated in an appropriate isolation medium, e.g. carrot agar/β/γ detection agar (bi-plate), blood agar, Columbia colistin nalidixic acid agar, phenylethyl agar or CHROMagar Strept. B. There are several commonly encountered colonizing microorganisms in the genitourinary tract and/or the rectum; however, their initial growth conditions in the GBS TransCultSwab have not yet been studied. Therefore, this study investigated the growth o f the 5 most commonly found colonizing microorganisms, namely, GBS, Enterococcus faecalis, Escherichia coli, Staphylococcus aureus and Corynebacterium sp., when they were present in the GBS TransCultSwab. Among them, GBS and E. faecalis were separately inoculated with 10^3 CFU on the swab, whereas E. coli, S. aureus, and Corynebacterium sp. were separately inoculated with 10^6 CFU. The swabs were then inserted into a GBS TransCultSwab individually and incubated at a 35℃ in an ambient incubator. After 0, 1, 2, 3, 4 and 5 hours, total viable counts for each of the swabs were performed in trypticase soy agar. The results indicated that the longer the incubation time, the greater the growth of GBS and E. faecalis. Their bacteria counts were increased by 154x and 86x respectively. In contrast, the growth of E. coli decreased by 36x, whereas the growth of S. aureus and Corynebacterium sp. were not significantly altered. Based on the above findings, we concluded that the CMP^(TM) GBS TransCultSwab can induce GBS growth, reduce the bacteria counts of other colonized bacteria. Therefore, the device can increase the isolation (detection) rate of GBS, and thus it is worthy of being integrated into the routine work of obstetricians and laboratory technologists.

並列關鍵字

CMP^(TM) GBS TransCultSwab ； Streptococcus agalactiae ； GBS ； growth of colonizing microorganisms in the genitourinary tract and/or the rectum