혈액배양에서 BacT/Alert 3D FA Plus와 FN Plus 레진배지 성능분석
Comprehensive Analysis of Blood Cultures Using BacT/Alert 3D FA Plus and FN Plus Media
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배경: 저자들은 한 대학병원에서 BacT/Alert 3D System (bioMérieux Inc., USA)의 혈액배양 레진 배지인 FA Plus와 FN Plus의 성능을 전향적으로 평가하였다. 방법: 총 2,994세트에 대해서 임상적으로 의의가 있는 세균의 양성률과 균 검출시간을 두 배지 간에 비교하였다. 또한 항균제 사용 유무에 따라 환자를 분류하고 두 군 간에 양성률을 비교하였다. 결과: 총 371세트(12.4%)에서 385개의 병원균이 배양되었다. 유당 비발효균과 효모균은 FA Plus에서 유의하게 높게 배양된 반면, 그람양성 알균과 그람음성 무산소성 간균은 FN Plus에서 유의하게 높게 배양되었다(P<0.001). 황색포도알균과 그람양성 알균은 FA Plus에서 유의하게 빠르게 배양되었다. 이미 항균제가 투여된 경우와 투여되지 않은 경우 양성률은 통계적으로 유의한 차이가 없었없었다(13.1%와 12.3%, P>0.05). 결론: 호기병인 FA Plus와 혐기병인 FN Plus는 상호 보완적으로 균이 검출되었다. FA Plus에서는 황색포도알균을 포함한 그람양성 알균이 신속하게 배양되었다. 레진 배지를 사용할 경우 BacT/Alert 3D System에서는 항균제 사용 유무에 의해 양성률은 차이가 없었다.
Abstract
Background: We prospectively evaluated the performance of blood culture resin media, FA Plus and FN Plus, of the BacT/Alert 3D System (bioMérieux Inc., USA) in a tertiary university-affiliated hospital. Methods: We obtained 2,994 blood culture sets. The positivity and time to detection (TTD) were compared between FA Plus and FN Plus for clinically significant microorganisms. We then categorized patients into two groups based on antibiotic treatment before blood culture to observe the difference of positivity between two groups. Results: Among 2,994 sets received, 371 (12.4%) yielded 385 clinically significant pathogens. Comparing FA Plus to FN Plus media, lactose non-fermenters (18 vs. 1; P<0.001) and yeasts (15 vs. 0; P<0.001) were recovered at a significantly higher rate using FA Plus, whereas gram-positive cocci (10 vs. 26; P=0.011) and gram-negative anaerobes (0 vs. 10 P=0.002) were isolated at a higher rate using FN Plus. In terms of detection time in FA Plus compared to that in FN Plus, Staphylococcus aureus (13.8 hr vs. 18.1 hr) and gram-positive cocci (14.1 hr vs. 20.3 hr) were detected significantly earlier in FA Plus (each, P<0.001). There was no statistically significant difference in positivity based on prior antibiotic use (13.1%, 65/498) compared to antibiotic naïve patients (12.3%, 306/2,496) (P>0.05). Conclusions: Complementary detection of microorganisms was observed between FA Plus and FN Plus. Gram-positive cocci including S. aureus grew faster in FA Plus. In addition, the rate of positivity was not affected by prior antibiotic therapy in BacT/Alert 3D resin media.
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