刘少娟 彭湘明 巫楚媚 赖艳榕 邓露露 刘瀚榆

[摘要]目的探討血培养直接药敏试验对血流感染性疾病的临床应用价值。方法选取血培养阳性标本55例，运用 K-B 法进行直接药敏试验和标准药敏试验，统计血培养革兰阳性球菌和革兰阴性杆菌7 h 和16 h 直接药敏试验结果的标准符合率并进行比较。结果血培养革兰阳性球菌7 h 和16 h 的直接药敏试验结果的标准符合率分别为78.261%和84.950%;血培养革兰阴性杆菌7 h 和16 h 的直接药敏试验结果的标准符合率分别为81.066%和91.912%。经统计学处理，直接药敏试验结果两个时间段之间差异有统计学意义，血培养革兰阳性球菌和革兰阴性杆菌16 h 药敏试验结果的标准符合率均高于7 h 药敏试验结果的标准符合率（ P <0.05）。结论血培养直接药敏试验耗时短，操作简便，培养16 h 的结果标准符合率较高，临床医生可参考血培养直接药敏结果为早期血流感染患者选取合适的抗生素治疗。

[关键词]血培养;直接药敏试验;标准药敏试验;纸片扩散法;菌液浓度

[中图分类号] R446.1  [文献标识码] A   [文章编号]2095-0616（2022）09-0142-05

Study on the clinical value of direct drug susceptibility testing of blood cultures for blood-borne infectious diseases

LIU 1Shaojuan    PENG  Xiangming   WU  Chumei（ 2）   LAI 1Yanrong    DENG  Lulu（ 1）   LIU 1Hanyu

1. Department of Clinical Laboratory， Guangzhou Red Cross Hospital， Guangdong， Guangzhou 510220， China;2. Foshan Nanhai District Fifth People's Hospital， Guangdong， Foshan 528231， China

[Abstract] Objective To investigate the clinical value of direct drug susceptibility testing of blood cultures for blood-borne infectious diseases. Methods A total of 55 blood culture positive samples were selected for direct drug susceptibility testing and standard drug susceptibility testing by the K-B method. The standard coincidence rates of 7-hour and 16-hour direct drug susceptibility testing results for blood culture gram- positive cocci and gram-negative bacilli were counted and compared. Results The standard coincidence rates of 7-hour and 16-hour direct drug susceptibility testing results for blood culture gram-positive cocci were 78.261% and 84.950%， respectively; the standard coincidence rates of 7-hour and 16-hour direct drug susceptibility testing results for blood culture gram-negative bacilli were 81.066% and 91.912%， respectively. Upon statistical processing， there was a statistically significant difference between the two periods in the results of direct drug susceptibility testing. The standard coincidence rate of 16-hour drug susceptibility testing results for blood culture gram-positive cocci and gram-negative bacilli was higher than that of 7-hour drug susceptibility testing results （P <0.05）. Conclusion The direct drug susceptibility testing of blood cultures is less time- consuming and easy to operate. The standard coincidence rate of the results for the 16-hour culture is relatively high. Clinicians can refer to the direct drug susceptibility testing results of blood cultures to select appropriate antibiotic therapy for patients with early blood stream infection.

[Key words] Blood culture; Direct drug susceptibility testing; Standard drug susceptibility testing; Disk diffusion method; Bacterial solution concentration

血流感染是极易引起机体中毒、感染及全身炎症反应的感染性疾病，起病急、病情凶险、病死率高[1-3]。对于严重的血流感染，早期明确病原菌并给予有效的抗菌药物治疗至关重要，可显著降低患者病死率[4-5]。按照传统的方法，血培养和药敏试验需要3～5 d 才得到结果以指导临床用药[6]。但是直接药敏试验用时较短，减少了细菌分离纯化的步骤，缩短报告时间。本研究是通过计算直接药敏试验的标准符合率，比较两个时间段标准符合率的差异，探讨能否运用直接药敏试验在较短的时间内得出准确的药敏结果，为临床提供用药参考依据。……