預培養延遲置入BacT/ALERT 3D血液培養系統對微生物偵測之影響

Effects of Pre-incubation on Detection of Microorganisms in Delayed-entry Samples in the BacT/ALERT 3D Blood Culturesystem

張善閔(Sam-Min Chang)；林信廷(Hsin-Ting Lin)；陳嘉文(Jia-Wen Chen)；李明輝(Ming-Hui Lee)；黃小萍(Shiao-Ping Huang)

BacT/ALERT 3D血液培養系統 ； 偵測時間 ； 預培養 ； 延遲置入 ； 培養陽性率 ； BacT/ALERT 3D automated system ； Time to detection ； Pre-Incubation ； Delayed entry ； Culture positivity

醫學與健康期刊

5卷1期（2016 / 03 / 01）

53 - 66

繁體中文

目的：探討血液培養瓶延遲置入BacT/ALERT 3D自動化血液培養系統對標準菌株之偵測時間和其陽性率之影響。方法：含菌的血液培養瓶在置入自動化血液培養系統前，預培養於不同的溫度(4°C、22°C、28°C、35°C和42°C)作用4小時、8小時、12小時、24小時以及48小時，分別記錄陽性偵測時間。結果除了見H. influenza或N. gonorrhoeae外，多數微生物之平均偵測時間隨著預培養溫度上升而縮短之負相關(p ＜ 0.05)。A. baumannii、P. aernginosa或B. thetaiotaomicron分別預培養於35°C/48小時，或22°C/48小時，28°C/24和48小時，35°C/24小時和48小時以及42°C/24小時和48小時，或42°C/48小時，血液培養系統仍無法偵測其陽性訊號，但隨後將其陰性血液培養瓶次培養後，顯示A. baumannii、P. aeruginosa或B. thetaiotaomicron均能回收。在延遲置入的環境下，C. albicans、N. gonorrhoeae以及S. pyogenes對機器偵測之陽性率和培養陽性率者均明顯地下降，不同於E. faecalis和H. ifluenzae僅各別預培養於4°C/48小時，或42°C/48小時被觀察到此結果。結論：根據我們的以上實驗結果，建議血液培養瓶若無法及時置入血液培養系統時，應先存放於22°C或28°C室溫環境下，且不超過24小時。

Objectives. This study examined the effect of delayed-entry of blood culture bottles loaded toBacT/ALERT 3D automated system on the time to detection and positive rate for detection ATCC strains. Methods. The blood culture bottles were inoculated with whole blood containing microorganisms, and then pre-incubated at various temperatures (4°C, 22°C, 28°C, 35°C and 42°C) for 4hr, 8hr, 12hr, 24hr, and 48 hr prior to loading into an automated system. Results. Mean TTD was inversely correlated with the pre-incubation temperature for most microorganisms (p＜0.05), except for H. influenza or N. gonorrhoeae. Organisms in bottles inoculated with the A. baumannii, P. aeruginosa and B.thetaiotaomicron remained undetected by the BacT/Alert system when set at 35°C/48hr, 22°C/48hr, 28°C/24 and 48hr, 35°C/24 and 48hr and 42°C/24 and 48hr, or 42°C/48hr, respectively. However, when all bottles were subjected to subculture for recovery the bacteria, they were found to produce false negative findings in bacterial growth of A. baumannii, P. aeruginosa and B.thetaiotaomicron. Both the positivity rate of detection and culture positivity were decreased significantly for C. albicans, N. gonorrhoeae and S. pyogenes under the condition of delayed entry. E. faecalis and H. influenza were pre-incubated at 4°C/48 hr or 42°C/48 hr, respectively. Conclusion. Taken together, these results suggest that all bottles from clinical settings should be maintained at 22°C or 28°C(RT) for up to24 hr before loading.

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