血液培养污染会云真菌阳性吗?

A. K. Sığ, Gulhadiye Avcu, Başak Yıldız Atikan, Mustafa Güney
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摘要

目的:血培养(BC)是诊断真菌血症的金标准。BC污染是世界范围内的一个主要问题,因为它可能延迟实际诊断。本研究的目的是通过添加抗菌剂的培养基长时间孵育(最多30天)来评估“污染物”小瓶,以观察任何真菌学生长。材料与方法:选取XXX医院1年的常规bc患者。使用Render BC System BC12-8 (Render Biotech Co. Ltd, Shenzhen, China)。受污染的小瓶进行再孵育和常规接种,每周共接种四周。如果有任何生长,用phoenix™100系统(Becton Dickinson, MA, USA)和玉米粉间80琼脂(RTA实验室,Kocaeli,土耳其)进行鉴定。采用CLSI盘片扩散法进行抗真菌药敏试验。结果:6047支BC中有3.9%(235支及新增138支)被污染。在常规接种的第一周(总孵育时间>8天),仅有1瓶中央静脉导管真菌生长。该分离株经鉴定为吉列蒙地假丝酵母复合体,对卡波霉素敏感。后一组患者在潜伏期第3天呈阳性。结论:国际指南建议
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Can Blood Culture Contaminaton Cloud Fungal Positivity?
Objective: Blood culture (BC) is gold standard for diagnosis of fungemia. Contamination of BC is a major problem worldwide, since it may delay actual diagnosis. The aim of this study was to evaluate “contaminant” vials with a prolonged incubation (max 30 days) with antimicrobial supplemented media to observe any mycological growth. Materials and Methods: Routine BCs optained patients of XXX Hospital for a year period were included. Render BC System BC12-8 (Render Biotech Co. Ltd., Shenzhen, China) were used. Contaminated vials were reincubated and conventionally-inoculated weekly for four weeks total. In case of any growth, identifications were done by PhoenixTM 100 system (Becton Dickinson, MA, USA) with cornmeal tween 80 agar (RTA Laboratories, Kocaeli, Turkey). Antifungal susceptibility testing were applied with CLSI disk diffusion method. Results: 3.9% (235 sets and additional 138 vials) of total 6047 BC sets were contaminated. Only one vial from central venous catheter showed fungal growth within the first week of conventional inoculation (>8th day of total incubation). The isolate was identified as Candida guilliermondii complex and susceptible to caspofungin. Latter set of this patient were positive in the 3rd day of incubation. Conclusion: International guidelines recommend
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