자동혈액배양법을 이용한 혈액 이외 체액배양의 평가
Evaluation of Automated Blood Culture System for Body Fluids Culture Other Than Blood
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배경: 연구자들은 혈액 이외의 체액 배양에서 자동 혈액배양 방법이 세균과 진균 배양에 있어서 기존의 고체배양법과 비교하여 우수한지 알아보기 위하여 연구하였다. 방법: 전체적으로 734검체(복수 457, 담즙 5, 복막투석액 28, 뇌척수액 32, 관절활액 165, 심낭액 17, 늑막액 30)가 본 연구에 사용되었다. 검체의 절반은 직접 자동혈액배양병(bioMeriux, Marcy-I’Etoile, France)에 접종하였고, 나머지는 3,000 rpm에서 10분 원심분리 후 기존의 고체배지에 접종하였다. 결과: 임상적으로 의의가 있는 미생물의 배양 양성은 자동혈액배양법에서 62 (8.5%), 고체배지법 61 (8.3%)로 방법상의 차이가 없었다(kappa index: 0.81, 95% confidence index: 0.75∼0.89). 세균 오염은 자동혈액배양법 11 (1.8%), 고체배지법 3 (0.4%)이었다. 결과 보고까지의 시간은 자동혈액배양법과 고체배지법이 각각 3.7일, 2.8일이었다(P=0.003). 결론: 혈액을 제외한 체액배양에서 자동혈액배양이 기존의 고형배지보다 임상적으로 의의 있는 균 발견에 향상이 없었다.
Abstract
Background: We investigated whether culture using an automated blood culture system enhances the recovery of bacteria and fungi from body fluids other than blood when compared to conventional solid media culture methods. Methods: A total of 734 specimens [ascites (n=457), bile (n=5), CAPD (n=28), CSF (n=32), joint fluids (n=165), pericardial fluid (n=17), and pleural fluid (n=30)] were included in the study. Half of the volume of each specimen was inoculated directly into automated blood culture bottles (bioMeriux, Marcy-I’Etoile, France). The remaining volume was inoculated onto conventional solid media (sheep blood agar, chocolate agar, and phenylethyl alcohol agar) after centrifuging at 3,000 rpm for 10 min. Results: Clinically significant microorganisms were isolated from 62 specimens (8.5%) by automated blood culture and 61 specimens (8.3%) by the conventional solid media culture (kappa index: 0.81, 95% confidence interval: 0.75∼0.89). Contamination was observed in 11 (1.8%) of the automated blood culture specimens and 3 (0.4%) of the solid media culture specimens. The mean turnaround times of the automated blood cultures and the conventional solid media cultures were 3.7 and 2.8 days, respectively (P＜ 0.0001). Conclusion: Compared with conventional culture methods, no improvement in the recovery of clinically significant microorganisms was noted with the use of the automated blood culture system for the culture of body fluids other than blood.
참고문헌 (16)
- Margaretten ME, "Does this adult patient have septic arthritis", JAMA, 297, pp.1478~1488 (2007)
- Bourbeau P, "Use of the BacT", Alert blood culture system for culture of sterile body fluids other than blood, 1998, pp.36, 3273~3277
- Azap OK, "Value of automatized blood culture systems in the diagnosis of continuous ambulatory peritoneal dialysis peritonitis", Transplant Proc, 통권 : 38, pp.411~412 (2006)
- Akcam FZ, "Evaluation of the Bactec microbial detection system for culturing miscellaneous sterile body fluids", Res Microbiol, 157, pp.433~436 (2006)
- Cetin ES, "Comparison of the BACTEC blood culture system versus conventional methods for culture of normally sterile body fluids", Adv Ther, 24, pp.1271~1277 (2007)
- Gibb AP, "Plates are better than broth for recovery of fastidious organisms from some specimen material", J Clin Microbiol, 37, pp.875~ (1999)
- Meredith FT, "Clinical utility of broth cultures of cerebrospinal fluid from patients at risk for shunt infections", J Clin Microbiol, 35, pp.3109~3111 (1997)
- Clinical and laboratory standards institute, "Principles and procedures for blood cultures; Approved guideline. CLSI document M47-A", CLSI, ~ (2009)
- Ortiz E, "Routine use of anaerobic blood cultures: are they still indicated", Am J Med, 108, pp.445~447 (2000)
- Dunbar SA, "Microscopic examination and broth culture of cerebrospinal fluid in diagnosis of meningitis", J Clin Microbiol, 36, pp.1617~1620 (1998)
- Jalava J, "Bacterial PCR in the diagnosis of joint infection", Ann Rheum Dis, 60, pp.287~289 (2001)
- Clarke MT, "Polymerase chain reaction can detect bacterial DNA in aseptically loose total hip arthroplasties", Clin Orthop Relat Res, (427), pp.132~137 (2004)
- Liebling MR, "Identification of Neisseria gonorrhoeae in synovial fluid using the polymerase chain reaction", Arthritis Rheum, 37, pp.702~709 (1994)
- Taylor-Robinson D, "Detection of Chlamydia trachomatis DNA in joints of reactive arthritis patients by polymerase chain reaction", Lancet, 340(8811), pp.81~82 (1992)
- van der Heijden IM, "Detection of mycobacteria in joint samples from patients with arthritis using a genus-specific polymerase chain reaction and sequence analysis", Rheumatology (Oxford), 38, pp.547~553 (1999)
- Nocton JJ, "Detection of Borrelia burgdorferi DNA by polymerase chain reaction in synovial fluid from patients with Lyme arthritis", N Engl J Med, 330, pp.229~234 (1994)