정규근무 시간 이후 자동화장비 투입 전 혈액배양 병의 보관조건이 균검출시간에 미치는 영향
Effect of Preincubation of Blood Culture Bottles in a BacT/Alert Unit Outside Laboratory Operating Hours on Detection Time
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배경: 혈액배양에서 균검출시간과 최종보고일은 자동화장비에 혈액배양 병을 투입하기 전 보관 조건에따라 영향을 받을 수 있다. 방법: 정규근무시간 이후 검사실에 도착한 혈액배양 병을 실온과 BacT/Alert (bioMerieux Inc.) 한 유닛에 보관한 후 다음날 아침에 주 장비에 투입하였다. 연구 기간은 각각 3개월이었고, 장비의 균검출시간과 최종보고일을 비교하였다. 결과: 균검출시간 중앙값은 장비 유닛 보관이 8.4시간으로 실온 보관의 12.4시간에 비해 유의하게 감소하였다(P＜0.001). 최종 동정 및 감수성 결과 보고가 2일 이내에 이루어진 것은 장비 유닛 보관이 30.6%, 실온 보관이 15.6%로 차이가 있었지만, 최종보고일의 통계적 유의성은 없었다(P=0.052). 장비위양성률은 장비 유닛 보관이 0.81%로서, 실온 보관 0.29%에 비해 유의하게 높았다(P＜0.001). 결론: 미생물검사실이 24시간 운용되지 않는 경우 자동혈액배양기 유닛을 응급검사실에 두고 사용하면 혈액배양 병을 실온에 보관할 때보다 균검출시간과 최종보고일을 단축시킬 수 있다. 하지만 이 경우 장비위양성이 늘어날 수 있다. [Ann Clin Microbiol 2014;17:105-109]
Abstract
Background: The pre-storage condition of blood culture bottles prior to entering the automated blood culture system may affect the time to detection (TTD) of microorganisms and the final report days. Methods: We compared the TTD and final report days according to the pre-incubation conditions after laboratory operating hours: room temperature (RT) vs. a BacT/Alert unit (BioMerieux Inc.) for 3 months respectively. All bottles were inserted into the main BacT/Alert system the next morning. Results: TTD was significantly reduced by pre-incubating bottles in a BacT/Alert unit (median, 8.4 h) compared to pre-storage at RT (median, 12.4 h) (P＜ 0.001). The final report of bacterial identification and drug susceptibility within 2 days was available for 24.4% of bottles pre-incubated in a BacT/Alert unit compared to 14.9% of those incubated at RT. The false positive results were significantly higher for pre-incubation in a BacT/Alert unit (0.81%) than for that (0.29%) at RT (P＜0.001). Conclusion: If a clinical microbiology laboratory is not operational for 24 hours, an automated blood culture unit might be a good alternative to reduce TTD and allow the submission of a faster final report compared to pre-storage at RT. However, false positive readings increased more than two-fold by pre-incubation in a BacT/Alert unit. (Ann Clin Microbiol 2014;17:-109)
참고문헌 (9)
- Seegmüller I, "Sensitivity of the BacT", ALERT FA-medium for detection of Pseudomonas aeruginosa in pre-incubated blood cultures and its temperaturedependence, 2004, pp.53, 869~874
- 고은하, "Effects of Preincubating Blood Culture Bottles at 37℃ during the Night Shift and of Collected Blood Volume on Time to Detection and Days to Final Report", Annals of Clinical Microbiology, 17(1), pp.14~19 (2014), 대한임상미생물학회
- Principles and procedures for blood cultures; approved guidline, "CLSI.", Clinical and Laboratory Standards Institute, ~, pp.CLSI document M47-A (2007)
- van der Velden LB, "Clinical impact of preincubation of blood cultures at 37°C", J Clin Microbiol, 49, pp.275~280 (2011)
- Kerremans JJ, "Immediate incubation of blood cultures outside routine laboratory hours of operation accelerates antibiotic switching", J Clin Microbiol, 47, pp.3520~3523 (2009)
- Saito T, "Delayed insertion of blood culture bottles into automated continuously monitoring blood culture systems increases the time from blood sample collection to the detection of microorganisms in bacteremic patients", J Infect Chemother, 15, pp.49~53 (2009)
- Janapatla RP, "Effect of overnight storage of blood culture bottles on bacterial detection time in the BACTEC 9240 blood culture system", J Microbiol Immunol Infect, 43, pp.126~132 (2010)
- 이동현, "Growth Dynamics of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa as a Function of Time to Detection in BacT", Alert 3D Blood Culture Bottles with Various Preincubation Conditions, 2013, pp.33(6), 406~409[DOI]
- Jardine LA, "Neonatal blood cultures: effect of delayed entry into the blood culture machine and bacterial concentration on the time to positive growth in a simulated model", J Paediatr Child Health, 45, pp.210~214 (2009)