BACTEC Peds Plus와 BacT/Alert PF 소아용 혈액배양병을 이용한 소아 환아의 혈액배양 비교
Comparison of the BACTEC Peds Plus Pediatric Blood Culture Bottle to the BacT/Alert PF Pediatric Blood Culture Bottle for Culturing Blood from Pediatric Patients
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배경: 소아 환자를 대상으로 BACTEC Peds Plus (Becton Dickinson, USA)와 BacT/Alert PF (bioMerieux, France) 소아용 혈액배양병을 이용한 혈액배양 검출률과 검출소요시간을 비교하고자 하였다. 방법: 2010년 1월부터 12월까지 1년간 강남성심병원 소아청소년과에 입원한 환자를 대상으로 하였다. 균혈증이 의심되는 환자의 혈액을 채취하여 BACTEC Peds Plus와 BacT/Alert PF 혈액배양병에 동량을 각각 분주하였다. BACTEC Peds Plus는 BACTEC FX (Becton Dickinson)에서, BacT/Alert PF는 BacT/Alert 3D (bioMerieux) 자동혈액배양기에서 5일간 혈액배양을 실시하였다. 5일 이내에 균이 검출되면 검출되기까지 소요된 시간을 기록하였다. 결과: 총 5,018 세트(1 세트, 1 BACTEC Peds Plus+1 BacT/Alert PF)의 혈액배양병을 채취하여 검사하였다. 총 195주의 분리균주 중 BacT/Alert PF와 BACTEC Peds Plus 배양병에서 각각 69% (134주)와 57% (112주)의 세균 또는 진균이 분리되었다. Micrococci, Bacillus spp., Corynebacterium spp.를 오염균으로 보았을 때 BacT/Alert PF의 오염률이 0.38%로 BACTEC Peds Plus의 0.16%보다 더 높았다(P=0.035). 전체적으로 평균 검출소요시간은 BACTEC Peds Plus (21.1시간)가BacT/Alert PF (25.2시간)보다 빨리 검출되었으나(P=0.021), Candida parapsilosis는 BACTEC Peds Plus (41.7시간)가 BacT/Alert PF (34.1시간)보다 더 늦게 검출되었다(P=0.028). 결론: BacT/Alert PF가 BACTECT Peds Plus 배양병에 비하여 균주의 검출률이 높았으나 오염률도 높았다. BACTEC Peds Plus가 BacT/Alert PF 배양병보다 전체적으로 빨리 균주가 검출되었다.
Abstract
Background: We compared the BACTEC Peds Plus (Becton Dickinson, USA) and BacT/Alert PF (bioMerieux, France) pediatric blood culture bottles in the context of recovery and time to detection (TTD) of bacteria and fungi from pediatric patients. Methods: Blood samples were collected for culture from pediatric patients who were hospitalized during 2010 at a university hospital. BACTEC Peds Plus and BacT/Alert PF bottles were placed in the BACTEC FX and BacT/Alert 3D blood culture system, respectively, and tested for 5 days. Bottles flagged by instruments as positive were removed from the instruments and the TTDs were recorded. Results: A total of 5,018 sets (1 set, 1 BACTEC Peds Plus and 1 BacT/Alert PF) were evaluated. Overall, the recovery proportions for BACTEC Peds Plus and BacT/Alert PF bottles were 57% (134/195) and 69% (112/195), respectively. There was a significant difference between the 0.38% contamination rate in BacT/Alert PF bottles and the 0.16% contamination rate in BACTEC Peds Plus bottles (P=0.035). The average TTD for all microorganisms was significantly decreased for the BACTEC Peds Plus bottles (P=0.021), but was increased for Candida parapsilosis compared to the results for the BacT/Alert PF bottles (P=0.028). Conclusion: We conclude that the rate of detection and contamination is higher when BacT/Alert PF bottles are used than when BACTEC Peds Plus bottles are used for pediatric blood culture. The BACTEC Peds Plus bottles detect nearly all enrolled microorganisms significantly faster than do the BacT/Alert PF bottles.
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