최고 치료농도의 항균제를 포함한 혈액배양에서 BACTEC Plus Aerobic/F 배양병과 BacT/Alert FA 배양병의 세균 검출능 비교
Comparison of BACTEC Plus Aerobic/F Media and BacT/ Alert FA Media to Detect Bacteria in Blood Culture Bottles Containing Peak Therapeutic Levels of Antimicrobials
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
배경: 항균제 치료를 받은 환자들의 혈액배양을 위해 항균제 제거 혈액 배양병이 개발되었다. 본 연구는 항균제 제거혈액배양병인 BACTEC Plus Aerobic/F (Becton Dickinson, USA, BACTEC Plus)와 BacT/Alert FA (bioMerieux Vitek, France)의 항균제 제거 능력을 비교하였다. 방법: BACTEC Plus와 BacT/Alert FA 배양병에 혈액 5 mL를 주입하고, 최고치료농도의 항균제 9종류와 7종의 표준균주와 임상분리 methicillin-resistant Staphylococcus aureus 1주를 접종하였다. 항균제/균주 조합을 각각 2개의 배양병에 접종하고 이를 3회 반복하였고 대조군은 동일한 방법으로 균주만 접종한 후 양성률과 검출 시간(time to detection, TTD)를비교하였다. 결과: BACTEC Plus와 BacT/Alert FA 배양병의 전체 양성률은 각각 76% (128/168)와 34% (57/168)이었다. BACTEC Plus 배양병에서 ampicillin과 ceftriaxone이 포함된 S. pneumoniae를 제외한 모든 그람 양성균이 검출되었으나, BacT/Alert FA 배양병에서는 vancomycin이 포함된 E. faecalis와 oxacillin이 포함된 MRSA를 제외하고 0∼50%의 그람 양성균이 검출되었다. Cefepime, cefotaxime, cefoxitin 및 ceftriaxone을 포함된 그람 음성균의 양성률은 BACTEC Plus 배양병에서 33∼100%이었고, BacT/Alert FA 배양병은 모두 음성이었다. Ciprofloxacin이 포함된 E. coli와 K. pneumoniae의 양성률은 BacT/Alert FA 배양병에서 100%이었고, BACTEC Plus 배양병은 33%이었다. 항균제/균주별 균 검출 시간은 ciprofloxacin이 포함된그람 음성균 배양을 제외하고 BACTEC Plus 배양병이 BacT/Alert FA 배양병보다 더 짧았다. 결론: 최고치료농도의 항균제를 포함한 혈액배양은 BACTEC Plus 배양병이 BacT/Alert FA 배양병보다 더 효과적이고빠르게 균을 검출하였다. [대한임상미생물학회지 2010;13:151-156]
Abstract
Background: Blood culture bottles with an antimicrobial removal system have been developed for patients treated with antibiotics. This study compared the ability of BACTEC Plus Aerobic/F bottles (Becton Dickinson,USA, BACTEC Plus) and BacT/Alert FA bottles (bio-Merieux Vitek, France) to effectively remove antimicrobials. Methods: BACTEC Plus and BacT/Alert FA bottles were spiked with 5 mL human blood, peak therapeutic concentrations of 9 antimicrobials and 7 type strains. Three rounds of duplicate testing were completed per antimicrobial/strain combination and growth control without antimicrobials. The time to detection (TTD) and recovery rates for bacteria were compared for both systems. Results: Overall, the BACTEC Plus and BacT/Alert FA recovered 76% (128/168) and 34% (57/168) of strains from test bottles, respectively. BACTEC Plus detected all of gram-positive bacteria except S. pneumoniae with ampicillin and ceftriaxone, but BacT/Alert FA detected 0∼50% of gram-positive bacteria except E. faecalis with vancomycin and methicillin-resistant S. aureus with oxacillin. In presence of cefepime, cefotaxime,cefoxitin and ceftriaxone, BACTEC Plus detected 33∼100% of gram-negative bacteria, but BacT/Alert FA did not detect gram-negative bacteria at all. In presence of ciprofloxacin, BacT/Alert FA detected 100% of E. coli and K. pneumoniae compared with 33% of those for BACTEC Plus. Overall, TTD of BACTEC Plus was shorter than that of BacT/Alert FA except in detecting gram-negative bacteria with ciprofloxacin (P＜0.05). Conclusion: BACTEC Plus Aerobic/F media containing peak therapeutic levels of antimicrobials are more effective and faster detection of bacteria than BacT/Alert FA media. (Korean J Clin Microbiol 2010;13:151-156)
참고문헌 (20)
- Weinstein MP, "The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults", Clin Infect Dis, 24, pp.584~602 (1997)
- Cho YK, "The influence of antimicrobial abuse to blood culture", Korean J Clin Microbiol, 1, pp.63~67 (1998)
- McGuire NM, "Evaluation of the BACTEC antimicrobial removal system for detection of bacteremia", J Clin Microbiol, 18, pp.449~451 (1983)
- Moody JA, "Evaluation of new blood culture processing systems", J Clin Microbiol, 20, pp.351~356 (1984)
- Courcol RJ, "Routine evaluation of BACTEC NR-16A and NR-17A media", J Clin Microbiol, 26, pp.1619~1622 (1988)
- Kelly MT, "Clinical comparison of isolator and BACTEC 660 resin media for blood culture", J Clin Microbiol, 28, pp.1925~1927 (1990)
- Tarrand JJ, "Clinical comparison of the resin-containing BACTEC 26 Plus and the Isolator 10 blood culturing systems", J Clin Microbiol, 29, pp.2245~2249 (1991)
- Weinstein MP, "Controlled evaluation of BacT", Alert standard aerobic and FAN aerobic blood culture bottles for detection of bacteremia and fungemia, 1995, pp.33, 978~981
- McDonald LC, "Clinical importance of increased sensitivity of BacT", Alert FAN aerobic and anaerobic blood culture bottles, 1996, pp.34, 2180~2184
- Wilson ML, "Controlled clinical comparison of BACTEC plus anaerobic", F to standard anaerobic, F medium for culturing blood from adults, pp.J Clin Microbiol, 2001[DOI]
- Pohlman JK, "Controlled clinical evaluation of BACTEC Plus Aerobic", F and BacT, J Clin Microbiol, pp.1995, 33[DOI]
- Flayhart D, "Comparison of BACTEC PLUS blood culture media to BacT", Alert FA blood culture media for detection of bacterial pathogens in samples containing therapeutic levels of antibiotics, 2007, pp.45, 816~821
- Vigano EF, "Use of simulated blood cultures for time to detection comparison between BacT", ALERT and BACTEC 9240 blood culture systems, 2002, pp.44, 235~240
- Vigano EF, "Use of simulated blood cultures for antibiotic effect on time to detection of the two blood culture systems BacT", ALERT and BACTEC 9240, 2004, pp.27, 235~248
- Amsden GW, "Tables of Antimicrobial Agent Pharmacology in Principles and Practice of Infectious Diseases. 6th ed", pp.635~700 (2005), Elservier Churchill Livingstone
- Lee GI, "Results of blood cultures at Ewha Womans’ University Hospital in recent 5 years", Korean J Clin Pathol, 8, pp.169~175 (1988)
- Kim HK, "Blood culture results at the Severance Hospital during 1984-1993", Infect Chemother, 28, pp.156~166 (1996)
- Kim MH, "Comparison of the nonradiometric BACTEC NR-660 system and conventional blood culture system for the detection of bacteremia", Korean J Clin Pathol, 14, pp.70~79 (1994)
- Ko GA, "Evaluation of VITAL automated blood culture system", Korean J Clin Pathol, 16, pp.556~562 (1996)
- 이대동, "BacT", Alert3D 장비를 이용한 혈액배양에서 FAN-A 호기성 배양병의 성능 평가, 2005, pp.8(2), 148~152[DOI]