首页 期刊 论文 学科刊群 资讯 加盟 关于
EN
image
Article(id=1210676787248501720, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1210676785113600955, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2021.05.07, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1608825600000, receivedDateStr=2020-12-25, revisedDate=1617206400000, revisedDateStr=2021-04-01, acceptedDate=null, acceptedDateStr=null, onlineDate=1766577439366, onlineDateStr=2025-12-24, pubDate=1622131200000, pubDateStr=2021-05-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1766577439366, onlineIssueDateStr=2025-12-24, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1766577439366, creator=13701087609, updateTime=1766577439366, updator=13701087609, issue=Issue{id=1210676785113600955, tenantId=1146029695717560320, journalId=1189873630562394117, year='2021', volume='46', issue='5', pageStart='425', pageEnd='530', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1766577438858, creator=13701087609, updateTime=1766718730270, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1211269404306838321, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1210676785113600955, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1211269404306838322, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1210676785113600955, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=468, endPage=473, ext={EN=ArticleExt(id=1210676787521131496, articleId=1210676787248501720, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Methodological evaluation of rapid identification and drug susceptibility testing of bloodstream infection bacteria, columnId=1190310110212751762, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Basic Research, runingTitle=null, highlight=null, articleAbstract=

Objective To compare the consistency and accuracy between rapid direct detection method (rapid method)and traditional detection method (traditional method) for bacterial identification and drug sensitivity test of positive blood culture specimens. Methods The bloodstream infection specimens of the outpatients, emergency patients and inpatients of the Chinese PLA General Hospital from 2019 to 2020 were collected and placed in a blood culture apparatus. After the blood culture alarm, positive blood culture specimens were collected. At the same time, the rapid method and the traditional method were used for culture. After culture, bacteria identification and drug susceptibility test were conducted respectively, and the consistency of bacteria identification and drug susceptibility test between the two methods was recorded and compared. Results Among the 149 positive blood specimens from patients with bloodstream infection, 79 strains of Gram-positive cocci and 70 strains of Gram-negative bacilli were identified by traditional method; 75 strains of Gram-positive cocci and 67 strains of Gram-negative bacilli were identified by the rapid method. Compared with the traditional method, the overall coincidence rate of the rapid method in identify bacteria was 95.3%(142/149), among which the coincidence rate of Gram-positive cocci was 94.9%(75/79), and that of Gram-negative bacilli was 95.7%(67/70). In the traditional method, 76 strains (96.2%) of Gram-positive cocci and 66 strains (94.3%) of Gram-negative bacteria can effectively identify their species; 3 strains (3.8%) of Gram-positive cocci and 4 strains (5.7%) of Gram-negative bacilli could effectively identify their genera. In the rapid method, 52 strains (69.3%) of Gram-positive cocci and 63 strains (94.0%) of Gram-negative bacilli could effectively identify their species, 20 strains (26.7%) of Gram-positive cocci and 3 strains (4.5%) of Gram-negative bacilli could effectively identify their genera. According to the criteria of drug sensitivity test results, the coincidence rates between the rapid method and the traditional method for drug sensitivity test of Gram-positive cocci and Gram-negative bacilli were more than or equal to 90.0%, the general error rates were less than 10.0%, the serious error rates were less than 3.0%except compound sulfamethoxazole, and the extremely serious error rates were less than 1.5%. Conclusion The rapid method can effectively shorten the time of identification and drug sensitivity test, and the identification results are accurate. It is helpful for clinicians to make a clear diagnosis and adjust the treatment plan in time, quickly shift from empirical use of broad-spectrum antibiotics to targeted treatment, and provide more effective treatment plan for patients.

, correspAuthors=Zhi-Hai Han, authorNote=null, correspAuthorsNote=
*E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Yi-Wei Ding, Si-Min Wu, Zhi-Hai Han), CN=ArticleExt(id=1210676787810538482, articleId=1210676787248501720, tenantId=1146029695717560320, journalId=1189873630562394117, language=CN, title=血流感染细菌快速鉴定及药敏试验的方法学评价, columnId=1190310110472798614, journalTitle=解放军医学杂志, columnName=基础研究, runingTitle=null, highlight=null, articleAbstract=

目的 比较快速直接检测方法(简称快速法)与传统检测方法(简称传统法)对血培养阳性标本进行细菌鉴定和药敏试验的一致性及准确性。方法 采集2019—2020年解放军总医院第六医学中心门急诊及住院患者血流感染标本，置于血培养仪中培养，血培养报警后收集血培养阳性标本，同时用快速法和传统法进行培养，培养后分别进行细菌鉴定和药敏试验，记录并比较两种方法鉴定细菌及药敏试验的一致性。结果 共收集149例血培养阳性标本，传统法鉴定出革兰阳性球菌79株、革兰阴性杆菌70株，快速法与传统法鉴定相符的革兰阳性球菌75株、革兰阴性杆菌67株。两种方法鉴定的一致率为95.3%(142/149)，鉴定革兰阳性球菌、革兰阴性杆菌的一致率分别为94.9%(75/79)、95.7%(67/70)。传统法中，76株(96.2%)革兰阳性球菌和66株(94.3%)革兰阴性杆菌可有效鉴定到种，3株(3.8%)革兰阳性球菌和4株(5.7%)革兰阴性杆菌可有效鉴定到属；快速法中，52株(69.3%)革兰阳性球菌和63株(94.0%)革兰阴性杆菌可有效鉴定到种，20株(26.7%)革兰阳性球菌和3株(4.5%)革兰阴性杆菌可有效鉴定到属。根据药敏试验结果判断标准，革兰阳性球菌和革兰阴性杆菌快速法与传统法药敏试验可接受标准符合率均≥90.0%，一般错误率均≤10.0%，严重错误率除复方新诺明外均≤3.0%，极严重错误率均≤1.5%。结论 快速法可有效缩短鉴定和药敏试验的时间且鉴定结果准确，有助于临床医师明确诊断并及时调整治疗方案，迅速从经验性使用广谱抗菌药物转向靶向治疗，为患者提供更加有效的治疗方案。

, correspAuthors=韩志海, authorNote=null, correspAuthorsNote=
韩志海，E-mail：
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=G3c1bVsVcZiEKGIxhNwENg==, magXml=46jdU9NSl7T16cDQZfao+Q==, pdfUrl=null, pdf=sn2KL5FBhx93y/YnQ3BH2Q==, pdfFileSize=819108, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=PJ0q2MAGxr8taaLuqZs2Kw==, mapNumber=null, authorCompany=null, fund=null, authors=

丁毅伟，硕士研究生，主管技师，主要从事微生物病原生物学方面的研究

, authorsList=丁毅伟, 吴思敏, 韩志海)}, authors=[Author(id=1210676788909445142, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1210676789005914146, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, authorId=1210676788909445142, language=EN, stringName=Yi-Wei Ding, firstName=Yi-Wei, middleName=null, lastName=Ding, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1Department of Respiratory and Critical Care Medicine, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1210676789073023014, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, authorId=1210676788909445142, language=CN, stringName=丁毅伟, firstName=毅伟, middleName=null, lastName=丁, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, address=1解放军总医院第六医学中心呼吸与危重症医学科，北京 100048, bio={"content":"

丁毅伟，硕士研究生，主管技师，主要从事微生物病原生物学方面的研究

"}, bioImg=null, bioContent=

丁毅伟，硕士研究生，主管技师，主要从事微生物病原生物学方面的研究

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1210676788024447998, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, xref=1, ext=[AuthorCompanyExt(id=1210676788028642304, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788024447998, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Respiratory and Critical Care Medicine, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China), AuthorCompanyExt(id=1210676788037029888, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788024447998, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1解放军总医院第六医学中心呼吸与危重症医学科，北京 100048)])]), Author(id=1210676789190463530, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1210676789282738225, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, authorId=1210676789190463530, language=EN, stringName=Si-Min Wu, firstName=Si-Min, middleName=null, lastName=Wu, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=2, address=2Department of Pathology, Hainan Cancer Hospital, Haikou 570312, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1210676789379207222, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, authorId=1210676789190463530, language=CN, stringName=吴思敏, firstName=思敏, middleName=null, lastName=吴, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=2, address=2海南省肿瘤医院病理科，海口 570312, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1210676788104138759, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, xref=2, ext=[AuthorCompanyExt(id=1210676788112527367, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788104138759, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Pathology, Hainan Cancer Hospital, Haikou 570312, China), AuthorCompanyExt(id=1210676788125110280, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788104138759, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2海南省肿瘤医院病理科，海口 570312)])]), Author(id=1210676789509230656, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=hanzhihai@sohu.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1210676789635059783, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, authorId=1210676789509230656, language=EN, stringName=Zhi-Hai Han, firstName=Zhi-Hai, middleName=null, lastName=Han, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, *, address=1Department of Respiratory and Critical Care Medicine, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1210676789718945868, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, authorId=1210676789509230656, language=CN, stringName=韩志海, firstName=志海, middleName=null, lastName=韩, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, *, address=1解放军总医院第六医学中心呼吸与危重症医学科，北京 100048, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1210676788024447998, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, xref=1, ext=[AuthorCompanyExt(id=1210676788028642304, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788024447998, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Respiratory and Critical Care Medicine, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China), AuthorCompanyExt(id=1210676788037029888, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788024447998, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1解放军总医院第六医学中心呼吸与危重症医学科，北京 100048)])])], keywords=[Keyword(id=1210676789807026261, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, orderNo=1, keyword=bloodstream infection), Keyword(id=1210676789899300953, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, orderNo=2, keyword=rapid identification), Keyword(id=1210676789983187038, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, orderNo=3, keyword=traditional identification), Keyword(id=1210676790050295908, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, orderNo=4, keyword=susceptibility test), Keyword(id=1210676790146764904, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, orderNo=1, keyword=血流感染), Keyword(id=1210676790260011118, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, orderNo=2, keyword=快速鉴定), Keyword(id=1210676790377451635, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, orderNo=3, keyword=传统鉴定), Keyword(id=1210676790473920634, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, orderNo=4, keyword=药敏鉴定)], refs=[Reference(id=1210676792231334102, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2019, volume=44, issue=11, pageStart=925, pageEnd=930, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Ma YT, Yang M, Zhang KX, journalName=Med J Chin PLA, refType=null, unstructuredReference=Ma YT, Yang M, Zhang KX, et al. Mass spectrometry of serum polypeptides of enterococcus faecium bloodstream infection in mice[J]. Med J Chin PLA, 2019, 44(11): 925-930., articleTitle=Mass spectrometry of serum polypeptides of enterococcus faecium bloodstream infection in mice, refAbstract=null), Reference(id=1210676792323608797, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2019, volume=44, issue=11, pageStart=925, pageEnd=930, url=null, language=null, rfNumber=[1], rfOrder=1, authorNames=麻雅婷, 杨明, 张可昕, journalName=解放军医学杂志, refType=null, unstructuredReference=[麻雅婷, 杨明, 张可昕, 等. 小鼠屎肠球菌血流感染的血清多肽质谱分析[J]. 解放军医学杂志, 2019, 44(11): 925-930.], articleTitle=小鼠屎肠球菌血流感染的血清多肽质谱分析, refAbstract=null), Reference(id=1210676792415883490, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2006, volume=34, issue=6, pageStart=1589, pageEnd=1596, url=null, language=null, rfNumber=[2], rfOrder=2, authorNames=Kumar A, Roberts D, Wood KE, journalName=Crit Care Med, refType=null, unstructuredReference=Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock[J]. Crit Care Med, 2006, 34(6): 1589-1596., articleTitle=Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock, refAbstract=null), Reference(id=1210676792474603751, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2009, volume=136, issue=5, pageStart=1237, pageEnd=1248, url=null, language=null, rfNumber=[3], rfOrder=3, authorNames=Kumar A, Ellis P, Arabi Y, journalName=Chest, refType=null, unstructuredReference=Kumar A, Ellis P, Arabi Y, et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock[J]. Chest, 2009, 136(5): 1237-1248., articleTitle=Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock, refAbstract=null), Reference(id=1210676792583655664, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2017, volume=70, issue=4, pageStart=361, pageEnd=366, url=null, language=null, rfNumber=[4], rfOrder=4, authorNames=Meda M, Clayton J, Varghese R, journalName=J Clin Pathol, refType=null, unstructuredReference=Meda M, Clayton J, Varghese R, et al. What are the critical steps in processing blood cultures? A prospective audit evaluating current practice of reporting blood cultures in a centralised laboratory serving secondary care hospitals[J]. J Clin Pathol, 2017, 70(4): 361-366., articleTitle=What are the critical steps in processing blood cultures? A prospective audit evaluating current practice of reporting blood cultures in a centralised laboratory serving secondary care hospitals, refAbstract=null), Reference(id=1210676792650764529, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2017, volume=12, issue=7, pageStart=e0181548, pageEnd=null, url=null, language=null, rfNumber=[5], rfOrder=5, authorNames=Hayakawa K, Mezaki K, KobayakawA M, journalName=PLoS One, refType=null, unstructuredReference=Hayakawa K, Mezaki K, KobayakawA M, et al. Impact of rapid identification of positive blood cultures using the Verigene system on antibiotic prescriptions: A prospective study of community-onset bacteremia in a tertiary hospital in Japan[J]. PLoS One, 2017, 12(7): e0181548., articleTitle=Impact of rapid identification of positive blood cultures using the Verigene system on antibiotic prescriptions: A prospective study of community-onset bacteremia in a tertiary hospital in Japan, refAbstract=null), Reference(id=1210676792747233527, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2016, volume=315, issue=8, pageStart=801, pageEnd=810, url=null, language=null, rfNumber=[6], rfOrder=6, authorNames=Singer M, Deutschman CS, Seymour CW, journalName=JAMA, refType=null, unstructuredReference=Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock(sepsis-3)[J]. JAMA, 2016, 315(8): 801-810., articleTitle=The third international consensus definitions for sepsis and septic shock(sepsis-3), refAbstract=null), Reference(id=1210676792873062658, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2020, volume=8, issue=6, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[7], rfOrder=7, authorNames=Wei W, Zhao HS, Ding HS, journalName=Trauma and Critical Care Medicine, refType=null, unstructuredReference=Wei W, Zhao HS, Ding HS, et al. Serum procalcitonin, peroxiredoxin-4 and high mobility group box-1 levels in sepsis patients with bloodstream infection and their influence on prognosis[J]. Trauma and Critical Care Medicine, 2020, 8(6): 469-470, 473., articleTitle=Serum procalcitonin, peroxiredoxin-4 and high mobility group box-1 levels in sepsis patients with bloodstream infection and their influence on prognosis, refAbstract=null), Reference(id=1210676792994697478, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2020, volume=8, issue=6, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[7], rfOrder=8, authorNames=魏威, 赵宏胜, 丁宏胜, journalName=创伤与急危重病医学, refType=null, unstructuredReference=[魏威, 赵宏胜, 丁宏胜, 等. 血流感染致脓毒症患者血清降钙素原、过氧化物还原酶4、高迁移率族蛋白 B1水平及其对预后影响[J]. 创伤与急危重病医学, 2020, 8(6): 469-470, 473.], articleTitle=血流感染致脓毒症患者血清降钙素原、过氧化物还原酶4、高迁移率族蛋白 B1水平及其对预后影响, refAbstract=null), Reference(id=1210676793086972174, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2014, volume=42, issue=8, pageStart=1749, pageEnd=1755, url=null, language=null, rfNumber=[8], rfOrder=9, authorNames=Ferrer R, Martin-loeches I, Phillips G, journalName=Crit Care Med, refType=null, unstructuredReference=Ferrer R, Martin-loeches I, Phillips G, et al. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement proGram[J]. Crit Care Med, 2014, 42(8): 1749-1755., articleTitle=Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement proGram, refAbstract=null), Reference(id=1210676793170858256, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2014, volume=56, issue=1, pageStart=472, pageEnd=478, url=null, language=null, rfNumber=[9], rfOrder=10, authorNames=Retamar P, Portillo MM, López-prieto MD, journalName=Antimicrob Agents Chemother, refType=null, unstructuredReference=Retamar P, Portillo MM, López-prieto MD, et al. Impact of inadequate empirical therapy on the mortality of patients with bloodstream infections: A propensity score based analysis[J]. Antimicrob Agents Chemother, 2014, 56(1): 472-478., articleTitle=Impact of inadequate empirical therapy on the mortality of patients with bloodstream infections: A propensity score based analysis, refAbstract=null), Reference(id=1210676793288298777, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2013, volume=68, issue=4, pageStart=947, pageEnd=953, url=null, language=null, rfNumber=[10], rfOrder=11, authorNames=Chen HC, Lin WL, Lin CC, journalName=J Antimicrob Chemother, refType=null, unstructuredReference=Chen HC, Lin WL, Lin CC, et al. Outcome of inadequate empirical antibiotic therapy in emergency department patients with community-onset bloodstream infections[J]. J Antimicrob Chemother, 2013, 68(4): 947-953., articleTitle=Outcome of inadequate empirical antibiotic therapy in emergency department patients with community-onset bloodstream infections, refAbstract=null), Reference(id=1210676793384767777, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2015, volume=46, issue=3, pageStart=266, pageEnd=271, url=null, language=null, rfNumber=[11], rfOrder=12, authorNames=Liscio JL, Mahoney MV, Hirsch EB, journalName=Int J Antimicrob Agents, refType=null, unstructuredReference=Liscio JL, Mahoney MV, Hirsch EB. Ceftolozane/tazobactam and ceftazidime/avibactam: Two novel β-lactam/β-lactamase inhibitor combination agents for the treatment of resistant Gram-negative bacterial infections[J]. Int J Antimicrob Agents, 2015, 46(3): 266-271., articleTitle=Ceftolozane/tazobactam and ceftazidime/avibactam: Two novel β-lactam/β-lactamase inhibitor combination agents for the treatment of resistant Gram-negative bacterial infections, refAbstract=null), Reference(id=1210676793502208292, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2017, volume=64, issue=6, pageStart=1369, pageEnd=1387, url=null, language=null, rfNumber=[12], rfOrder=13, authorNames=Sharma R, Francois D, Hammerschlag MR, journalName=Pediatr Clin North Am, refType=null, unstructuredReference=Sharma R, Francois D, Hammerschlag MR. New antimicrobial agents for the treatment of staphylococcal infections in children[J]. Pediatr Clin North Am, 2017, 64(6): 1369-1387., articleTitle=New antimicrobial agents for the treatment of staphylococcal infections in children, refAbstract=null), Reference(id=1210676793623843115, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2017, volume=27, issue=12, pageStart=2676, pageEnd=2679, url=null, language=null, rfNumber=[13], rfOrder=14, authorNames=Ma J, Yu WJ, Hu BJ, journalName=Chin J Nosocomiol, refType=null, unstructuredReference=Ma J, Yu WJ, Hu BJ, et al. Rapid method for direct identification of bacteria in blood culture broth using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry[J]. Chin J Nosocomiol, 2017, 27(12): 2676-2679., articleTitle=Rapid method for direct identification of bacteria in blood culture broth using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, refAbstract=null), Reference(id=1210676793737089326, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2017, volume=27, issue=12, pageStart=2676, pageEnd=2679, url=null, language=null, rfNumber=[13], rfOrder=15, authorNames=马坚, 俞万钧, 胡必杰, journalName=中华医院感染学杂志, refType=null, unstructuredReference=[马坚, 俞万钧, 胡必杰, 等. 通过基质辅助激光解析电离飞行时间质谱系统直接快速鉴定阳性血培养[J]. 中华医院感染学杂志, 2017, 27(12): 2676-2679.], articleTitle=通过基质辅助激光解析电离飞行时间质谱系统直接快速鉴定阳性血培养, refAbstract=null), Reference(id=1210676793841946932, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2017, volume=26, issue=23, pageStart=13, pageEnd=17, url=null, language=null, rfNumber=[14], rfOrder=16, authorNames=Li C, Ding SF, Huang Y, journalName=Chin J Nosocomiol, refType=null, unstructuredReference=Li C, Ding SF, Huang Y, et al. VITEK-MS direct identification of bacteria from positive BacT/ALERT 3D blood culture bottles[J]. Chin J Nosocomiol, 2017, 26(23): 13-17., articleTitle=VITEK-MS direct identification of bacteria from positive BacT/ALERT 3D blood culture bottles, refAbstract=null), Reference(id=1210676793946804538, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2017, volume=26, issue=23, pageStart=13, pageEnd=17, url=null, language=null, rfNumber=[14], rfOrder=17, authorNames=李聪, 丁守甫, 黄颖, journalName=中华医院感染学杂志, refType=null, unstructuredReference=[李聪, 丁守甫, 黄颖, 等. VITEK-MS质谱仪直接检测BacT/ALERT 3D仪阳性血培养瓶微生物的实验研究[J]. 中华医院感染学杂志, 2017, 26(23): 13-17.], articleTitle=VITEK-MS质谱仪直接检测BacT/ALERT 3D仪阳性血培养瓶微生物的实验研究, refAbstract=null), Reference(id=1210676794026496319, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2019, volume=20, issue=3, pageStart=219, pageEnd=224, url=null, language=null, rfNumber=[15], rfOrder=18, authorNames=Gu YF, Li Y, Zhang XL, journalName=Surg Infect(Larchmt), refType=null, unstructuredReference=Gu YF, Li Y, Zhang XL, et al. A new method aimed to quickly identify pathogen and drug susceptibility test based on matrix-assisted laser desorption/ionization time of flight mass spectrometry combined with flow cytometry[J]. Surg Infect(Larchmt), 2019, 20(3): 219-224., articleTitle=A new method aimed to quickly identify pathogen and drug susceptibility test based on matrix-assisted laser desorption/ionization time of flight mass spectrometry combined with flow cytometry, refAbstract=null), Reference(id=1210676794114576707, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2012, volume=73, issue=1, pageStart=21, pageEnd=26, url=null, language=null, rfNumber=[16], rfOrder=19, authorNames=Saffert RT, Cunningham SA, Mandrekar J, journalName=Diagn Microbiol Infect Dis, refType=null, unstructuredReference=Saffert RT, Cunningham SA, Mandrekar J, et al. Comparison of three preparatory methods for detection of bacteremia by MALDI-TOF mass spectrometry[J]. Diagn Microbiol Infect Dis, 2012, 73(1): 21-26., articleTitle=Comparison of three preparatory methods for detection of bacteremia by MALDI-TOF mass spectrometry, refAbstract=null), Reference(id=1210676794219434313, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2016, volume=16, issue=1, pageStart=185, pageEnd=null, url=null, language=null, rfNumber=[17], rfOrder=20, authorNames=Barnini S, Brucculeri V, Morici P, journalName=BMC Microbiol, refType=null, unstructuredReference=Barnini S, Brucculeri V, Morici P, et al. A new rapid method for direct antimicrobial susceptibility testing of bacteria from positive blood cultures[J]. BMC Microbiol, 2016, 16(1): 185., articleTitle=A new rapid method for direct antimicrobial susceptibility testing of bacteria from positive blood cultures, refAbstract=null), Reference(id=1210676794311709006, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, doi=null, pmid=null, pmcid=null, year=2020, volume=39, issue=10, pageStart=2003, pageEnd=null, url=null, language=null, rfNumber=[18], rfOrder=21, authorNames=Oberhettinger P, Zieger J, Autenrieth I, journalName=Eur J Clin Microbiol Infect Dis, refType=null, unstructuredReference=Oberhettinger P, Zieger J, Autenrieth I, et al. Correction to: Evaluation of two rapid molecular test systems to establish an algorithm for fast identification of bacterial pathogens from positive blood cultures[J]. Eur J Clin Microbiol Infect Dis, 2020, 39(10): 2003., articleTitle=Correction to: Evaluation of two rapid molecular test systems to establish an algorithm for fast identification of bacterial pathogens from positive blood cultures, refAbstract=null)], funds=[Fund(id=1210676791874818242, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, awardId=CXPY201915, language=EN, fundingSource=Innovation and Cultivation Fund of the Sixth Medical Center of Chinese PLA General Hospital(CXPY201915), fundOrder=null, country=null), Fund(id=1210676791937732808, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, awardId=CXPY201915, language=CN, fundingSource=解放军总医院第六医学中心创新培育基金(CXPY201915), fundOrder=null, country=null), Fund(id=1210676792030007499, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, awardId=CLB20J019, language=EN, fundingSource=General Research Project of Military Logistics(CLB20J019), fundOrder=null, country=null), Fund(id=1210676792113893584, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, awardId=CLB20J019, language=CN, fundingSource=军队后勤科研面上项目(CLB20J019), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1210676788024447998, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, xref=1, ext=[AuthorCompanyExt(id=1210676788028642304, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788024447998, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Respiratory and Critical Care Medicine, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China), AuthorCompanyExt(id=1210676788037029888, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788024447998, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1解放军总医院第六医学中心呼吸与危重症医学科，北京 100048)]), AuthorCompany(id=1210676788104138759, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, xref=2, ext=[AuthorCompanyExt(id=1210676788112527367, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788104138759, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Pathology, Hainan Cancer Hospital, Haikou 570312, China), AuthorCompanyExt(id=1210676788125110280, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, companyId=1210676788104138759, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2海南省肿瘤医院病理科，海口 570312)])], figs=[ArticleFig(id=1210676790633304192, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, label=Tab.1, caption=

Judgment criteria for the results of drug sensitivity test of rapid method and traditional method

, figureFileSmall=null, figureFileBig=null, tableContent=
名称快速法传统法可接受标准
CASS
RRCA≥90.0%
 II
MIEIR/SMIE≤10.0%
R/SI
MERSME≤3.0%
VMESRVME≤1.5%
), ArticleFig(id=1210676790721384583, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, label=表1, caption=

快速法与传统法药敏试验结果判断标准

, figureFileSmall=null, figureFileBig=null, tableContent=
名称快速法传统法可接受标准
CASS
RRCA≥90.0%
 II
MIEIR/SMIE≤10.0%
R/SI
MERSME≤3.0%
VMESRVME≤1.5%
), ArticleFig(id=1210676790784299146, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, label=Tab.2, caption=

Analysis of the consistency rate of rapid method and traditional method in identification of positive blood culture specimen

, figureFileSmall=null, figureFileBig=null, tableContent=
病原菌传统法(株)快速法(株)一致率(%)
革兰阳性球菌797594.9
 葡萄球菌656193.8
 肠球菌1212100.0
 链球菌22100.0
革兰阴性杆菌706795.7
 肠杆菌科6363100.0
 非发酵菌7457.1
合计14914295.3
), ArticleFig(id=1210676790893351056, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, label=表2, caption=

血培养阳性标本快速法与传统法鉴定一致率分析

, figureFileSmall=null, figureFileBig=null, tableContent=
病原菌传统法(株)快速法(株)一致率(%)
革兰阳性球菌797594.9
 葡萄球菌656193.8
 肠球菌1212100.0
 链球菌22100.0
革兰阴性杆菌706795.7
 肠杆菌科6363100.0
 非发酵菌7457.1
合计14914295.3
), ArticleFig(id=1210676791002402965, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, label=Tab.3, caption=

Accuracy analysis of rapid method and traditional method in identification of Gram-positive cocci [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
革兰阳性球菌2.300~3.000分2.000~2.299分1.700~1.999分<1.700分
传统法快速法传统法快速法传统法快速法传统法快速法
金黄色葡萄球菌7(8.9)2(2.7)7(8.9)10(13.3)01(1.3)00
头葡萄球菌1(1.3)1(1.3)6(7.6)5(6.7)0000
孔氏葡萄球菌00001(1.3)001(1.3)
佩滕科夫葡萄球菌001(1.3)1(1.3)0000
科氏葡萄球菌001(1.3)00000
溶血葡萄球菌006(7.6)1(1.3)1(1.3)5(6.7)01(1.3)
人葡萄球菌4(5.1)4(5.3)14(17.7)6(8.0)1(1.3)9(12.0)00
表皮葡萄球菌1(1.3)014(17.7)9(12.0)04(5.3)01(1.3)
无乳链球菌1(1.3)01(1.3)2(2.7)0000
粪肠球菌01(1.3)5(6.3)3(4.0)01(1.3)00
屎肠球菌2(2.5)2(2.7)5(6.3)5(6.7)0000
合计16(20.3)10(13.3)60(75.9)42(56.0)3(3.8)20(26.7)03(4.0)
), ArticleFig(id=1210676791103066266, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, label=表3, caption=

快速法与传统法鉴定革兰阳性球菌的准确性分析[株(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
革兰阳性球菌2.300~3.000分2.000~2.299分1.700~1.999分<1.700分
传统法快速法传统法快速法传统法快速法传统法快速法
金黄色葡萄球菌7(8.9)2(2.7)7(8.9)10(13.3)01(1.3)00
头葡萄球菌1(1.3)1(1.3)6(7.6)5(6.7)0000
孔氏葡萄球菌00001(1.3)001(1.3)
佩滕科夫葡萄球菌001(1.3)1(1.3)0000
科氏葡萄球菌001(1.3)00000
溶血葡萄球菌006(7.6)1(1.3)1(1.3)5(6.7)01(1.3)
人葡萄球菌4(5.1)4(5.3)14(17.7)6(8.0)1(1.3)9(12.0)00
表皮葡萄球菌1(1.3)014(17.7)9(12.0)04(5.3)01(1.3)
无乳链球菌1(1.3)01(1.3)2(2.7)0000
粪肠球菌01(1.3)5(6.3)3(4.0)01(1.3)00
屎肠球菌2(2.5)2(2.7)5(6.3)5(6.7)0000
合计16(20.3)10(13.3)60(75.9)42(56.0)3(3.8)20(26.7)03(4.0)
), ArticleFig(id=1210676791224701088, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, label=Tab.4, caption=

Accuracy analysis of rapid method and traditional method in identification of Gram-negative bacilli [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
革兰阴性杆菌2.300~3.000分2.000~2.299分1.700~1.999分<1.700分
传统法快速法传统法快速法传统法快速法传统法快速法
解鸟氨酸拉乌尔菌1(1.4)1(1.5)000000
肺炎克雷伯菌14(20.0)13(19.4)13(18.6)13(19.4)01(1.5)00
阴沟肠杆菌001(1.4)1(1.5)1(1.4)001(1.5)
黄褐假单胞菌001(1.4)001(1.5)00
黏质沙雷菌001(1.4)1(1.5)0000
鲍曼不动杆菌01(1.5)1(1.4)00000
产气肠杆菌2(2.9)2(3.0)4(5.7)4(6.0)1(1.4)1(1.5)00
大肠埃希菌11(15.7)13(19.4)13(18.6)13(19.4)2(2.9)000
铜绿假单胞菌001(1.4)00000
洋葱伯克霍尔德菌1(1.4)02(2.9)1(1.5)0000
合计29(41.4)30(44.8)37(52.9)33(49.3)4(5.7)3(4.5)01(1.5)
), ArticleFig(id=1210676791375696042, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, label=表4, caption=

快速法与传统法鉴定革兰阴性杆菌的准确性分析[株(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
革兰阴性杆菌2.300~3.000分2.000~2.299分1.700~1.999分<1.700分
传统法快速法传统法快速法传统法快速法传统法快速法
解鸟氨酸拉乌尔菌1(1.4)1(1.5)000000
肺炎克雷伯菌14(20.0)13(19.4)13(18.6)13(19.4)01(1.5)00
阴沟肠杆菌001(1.4)1(1.5)1(1.4)001(1.5)
黄褐假单胞菌001(1.4)001(1.5)00
黏质沙雷菌001(1.4)1(1.5)0000
鲍曼不动杆菌01(1.5)1(1.4)00000
产气肠杆菌2(2.9)2(3.0)4(5.7)4(6.0)1(1.4)1(1.5)00
大肠埃希菌11(15.7)13(19.4)13(18.6)13(19.4)2(2.9)000
铜绿假单胞菌001(1.4)00000
洋葱伯克霍尔德菌1(1.4)02(2.9)1(1.5)0000
合计29(41.4)30(44.8)37(52.9)33(49.3)4(5.7)3(4.5)01(1.5)
), ArticleFig(id=1210676791459582125, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, label=Tab.5, caption=

Analysis of coincidence rate and error rate of rapid method and traditional method in drug sensitivity test of Gram-positive cocci [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
抗菌药物MIEMEVMECA
头孢西丁00065(100.0)
青霉素00079(100.0)
氨苄西林00014(100.0)
苯唑西林00065(100.0)
高水平庆大霉素0002(100.0)
高水平链霉素0002(100.0)
庆大霉素00065(100.0)
环丙沙星1(1.3)0079(98.7)
左氧氟沙星00079(100.0)
莫西沙星1(1.3)0079(98.7)
诱导性克林霉素001(1.5)65(98.5)
红霉素00079(100.0)
氯林霉素01(1.3)079(98.7)
奎奴普丁/达福普汀00079(100.0)
利奈唑胺00079(100.0)
替考拉宁00079(100.0)
万古霉素00079(100.0)
四环素01(1.3)079(98.7)
替加环素00079(100.0)
呋喃妥因3(3.8)0079(96.2)
利福平10065(98.5)
复方新诺明02(3.1)065(96.9)
), ArticleFig(id=1210676791551856817, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, label=表5, caption=

革兰阳性球菌快速法与传统法药敏试验结果的符合率和错误率分析[株(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
抗菌药物MIEMEVMECA
头孢西丁00065(100.0)
青霉素00079(100.0)
氨苄西林00014(100.0)
苯唑西林00065(100.0)
高水平庆大霉素0002(100.0)
高水平链霉素0002(100.0)
庆大霉素00065(100.0)
环丙沙星1(1.3)0079(98.7)
左氧氟沙星00079(100.0)
莫西沙星1(1.3)0079(98.7)
诱导性克林霉素001(1.5)65(98.5)
红霉素00079(100.0)
氯林霉素01(1.3)079(98.7)
奎奴普丁/达福普汀00079(100.0)
利奈唑胺00079(100.0)
替考拉宁00079(100.0)
万古霉素00079(100.0)
四环素01(1.3)079(98.7)
替加环素00079(100.0)
呋喃妥因3(3.8)0079(96.2)
利福平10065(98.5)
复方新诺明02(3.1)065(96.9)
), ArticleFig(id=1210676791665103035, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=EN, label=Tab.6, caption=

Analysis of coincidence rate and error rate of rapid method and traditional method in drug sensitivity test of Gram-negative bacilli [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
抗菌药物MIEMEVMECA
氨苄西林00033(100.0)
氨苄青霉素/舒巴坦1(3.0)0033(97.0)
哌拉西林00033(100.0)
头孢唑啉00033(100.0)
头孢呋辛00033(100.0)
头孢呋新酯00033(100.0)
头孢替坦00033(100.0)
头孢曲松00033(100.0)
庆大霉素00033(100.0)
呋喃妥因00033(100.0)
替卡西林/克拉维酸00037(100.0)
头孢哌酮/舒巴坦1(2.7)0037(97.3)
头孢吡肟1(2.7)0037(97.3)
强力霉素00037(100.0)
米诺环素2(5.4)0037(94.6)
替加环素1(2.7)0037(97.3)
多黏菌素00037(100.0)
哌拉西林/他唑巴坦00070(100.0)
氨曲南00070(100.0)
亚胺培南00070(100.0)
美罗培南1(1.4)0070(98.6)
阿米卡星2(2.9)0070(97.1)
妥布霉素00070(100.0)
环丙沙星1(1.4)0070(98.6)
左氧氟沙星1(1.4)0070(98.6)
复方新诺明00070(100.0)
), ArticleFig(id=1210676791748989117, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1210676787248501720, language=CN, label=表6, caption=

革兰阴性杆菌快速法与传统法药敏试验结果的符合率和错误率分析[株(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
抗菌药物MIEMEVMECA
氨苄西林00033(100.0)
氨苄青霉素/舒巴坦1(3.0)0033(97.0)
哌拉西林00033(100.0)
头孢唑啉00033(100.0)
头孢呋辛00033(100.0)
头孢呋新酯00033(100.0)
头孢替坦00033(100.0)
头孢曲松00033(100.0)
庆大霉素00033(100.0)
呋喃妥因00033(100.0)
替卡西林/克拉维酸00037(100.0)
头孢哌酮/舒巴坦1(2.7)0037(97.3)
头孢吡肟1(2.7)0037(97.3)
强力霉素00037(100.0)
米诺环素2(5.4)0037(94.6)
替加环素1(2.7)0037(97.3)
多黏菌素00037(100.0)
哌拉西林/他唑巴坦00070(100.0)
氨曲南00070(100.0)
亚胺培南00070(100.0)
美罗培南1(1.4)0070(98.6)
阿米卡星2(2.9)0070(97.1)
妥布霉素00070(100.0)
环丙沙星1(1.4)0070(98.6)
左氧氟沙星1(1.4)0070(98.6)
复方新诺明00070(100.0)
)], attaches=null, journal=Journal(id=1146441329971666965, delFlag=0, nameCn=解放军医学杂志, nameEn=Medical Journal of Chinese People’s Liberation Army, nameHistory1=null, nameHistory2=null, issn=0577-7402, eissn=null, cn=11-1056/R, coden=null, periodic=0, language=CN, oaType=是, ccby=CC BY-NC-ND, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=6srot5PcoYX30Oa4xeTmeg==, journalPrice=null, startedYear=null, abbrevIsoEn=null, journalRemark=null, publicationField=null, createdTime=1751262512917, updatedTime=1761735725513, createdBy=18614031015, updatedBy=13701087609, firstLetterCn=M, firstLetterEn=M, subjectCode=Life Sciences, subjectName=Life Sciences, subjectCodeEn=Life Sciences, subjectNameEn=null, picCn=6srot5PcoYX30Oa4xeTmeg==, picEn=ELwBh5xqrSTlIs7HmSNt2Q==, jcr=null, cjcr=null, exts=[JournalExt(id=1190369167564968109, language=CN, name=解放军医学杂志, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1761735725537, updatedTime=1761735725537, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=#, submissionEditorUrl=#, submissionReviewUrl=#, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1190369167615299758, language=EN, name=Medical Journal of Chinese People’s Liberation Army, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1761735725549, updatedTime=1761735725549, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=#, submissionEditorUrl=#, submissionReviewUrl=#, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1189873630562394117, websiteList=[Website(id=1189873845923287108, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1189873630562394117, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN, language=CN, createTime=1761617631655, createBy=18614031015, updateTime=1761622010471, updateBy=18614031015, name=解放军医学杂志-中文, tplId=1146099689490845704, title=解放军医学杂志, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1189924939378520839, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=articleTextType, value=kx, createTime=1761629813284, updateTime=1761629813284, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939353355012, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=banner, value=null, createTime=1761629813278, updateTime=1761629813278, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939399492362, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=grayFlag, value=0, createTime=1761629813289, updateTime=1761629813289, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939344966403, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=logo, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/file/pic?fileId=+zXjYVhun8ZOAA6+aKx2hw==, createTime=1761629813276, updateTime=1761629813276, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939412075276, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=minRunFlag, value=0, createTime=1761629813292, updateTime=1761629813292, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939374326534, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/file/pic, createTime=1761629813283, updateTime=1761629813283, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939407880971, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=silenceFlag, value=0, createTime=1761629813291, updateTime=1761629813291, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939361743621, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1761629813280, updateTime=1761629813280, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939386909448, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=themeColor, value=null, createTime=1761629813286, updateTime=1761629813286, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939395298057, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=themeStyle, value=null, createTime=1761629813288, updateTime=1761629813288, creator=18614031015, updator=18614031015)]), Website(id=1189873846057504839, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1189873630562394117, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN, language=EN, createTime=1761617631687, createBy=18614031015, updateTime=1761622030030, updateBy=18614031015, name=解放军医学杂志-英文, tplId=1146101810881728533, title=Medical Journal of Chinese People’s Liberation Army, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1189924968168223505, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=articleTextType, value=kx, createTime=1761629820148, updateTime=1761629820148, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968147251982, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=banner, value=null, createTime=1761629820143, updateTime=1761629820143, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968185000724, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=grayFlag, value=0, createTime=1761629820152, updateTime=1761629820152, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968138863373, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=logo, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/file/pic?fileId=+zXjYVhun8ZOAA6+aKx2hw==, createTime=1761629820141, updateTime=1761629820141, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968197583638, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=minRunFlag, value=0, createTime=1761629820155, updateTime=1761629820155, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968159834896, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/file/pic, createTime=1761629820146, updateTime=1761629820146, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968193389333, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=silenceFlag, value=0, createTime=1761629820154, updateTime=1761629820154, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968155640591, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1761629820145, updateTime=1761629820145, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968172417810, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=themeColor, value=null, createTime=1761629820149, updateTime=1761629820149, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968180806419, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=themeStyle, value=null, createTime=1761629820151, updateTime=1761629820151, creator=18614031015, updator=18614031015)])], journalTitle=解放军医学杂志, weixinUrl=null, journalUrl=http://zh.jfjyxzz.org.cn/, iacademicId=null, status=1, seqNo=null, journalTitleEn=Medical Journal of Chinese People’s Liberation Army, journalPhotoCn=6srot5PcoYX30Oa4xeTmeg==, journalPhotoEn=ELwBh5xqrSTlIs7HmSNt2Q==, journalFirstLetter=M, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false), detailUrlCn=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/10.11855/j.issn.0577-7402.2021.05.07, detailUrlEn=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/10.11855/j.issn.0577-7402.2021.05.07, pdfUrlCn=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/PDF/10.11855/j.issn.0577-7402.2021.05.07, pdfUrlEn=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/PDF/10.11855/j.issn.0577-7402.2021.05.07, aliStartDate=null, aliEndDate=null, collectionFlag=false, citedCount=null, citedUrl=null, reference=null)
收藏切换
血流感染细菌快速鉴定及药敏试验的方法学评价
收藏切换
PDF下载
丁毅伟 1 , 吴思敏 2 , 韩志海 1, *
解放军医学杂志 | 基础研究 2021,46(5): 468-473
收起
收藏切换
解放军医学杂志 | 基础研究 2021, 46(5): 468-473
血流感染细菌快速鉴定及药敏试验的方法学评价
全屏
丁毅伟1, 吴思敏2, 韩志海1, *
作者信息
  • 1解放军总医院第六医学中心呼吸与危重症医学科，北京 100048
  • 2海南省肿瘤医院病理科，海口 570312

    • 丁毅伟，硕士研究生，主管技师，主要从事微生物病原生物学方面的研究

通讯作者:

韩志海，E-mail：
Methodological evaluation of rapid identification and drug susceptibility testing of bloodstream infection bacteria
Yi-Wei Ding1, Si-Min Wu2, Zhi-Hai Han1, *
Affiliations
  • 1Department of Respiratory and Critical Care Medicine, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
  • 2Department of Pathology, Hainan Cancer Hospital, Haikou 570312, China
出版时间: 2021-05-28 doi: 10.11855/j.issn.0577-7402.2021.05.07
文章导航
收藏切换
摘要
收起

目的 比较快速直接检测方法(简称快速法)与传统检测方法(简称传统法)对血培养阳性标本进行细菌鉴定和药敏试验的一致性及准确性。方法 采集2019—2020年解放军总医院第六医学中心门急诊及住院患者血流感染标本，置于血培养仪中培养，血培养报警后收集血培养阳性标本，同时用快速法和传统法进行培养，培养后分别进行细菌鉴定和药敏试验，记录并比较两种方法鉴定细菌及药敏试验的一致性。结果 共收集149例血培养阳性标本，传统法鉴定出革兰阳性球菌79株、革兰阴性杆菌70株，快速法与传统法鉴定相符的革兰阳性球菌75株、革兰阴性杆菌67株。两种方法鉴定的一致率为95.3%(142/149)，鉴定革兰阳性球菌、革兰阴性杆菌的一致率分别为94.9%(75/79)、95.7%(67/70)。传统法中，76株(96.2%)革兰阳性球菌和66株(94.3%)革兰阴性杆菌可有效鉴定到种，3株(3.8%)革兰阳性球菌和4株(5.7%)革兰阴性杆菌可有效鉴定到属；快速法中，52株(69.3%)革兰阳性球菌和63株(94.0%)革兰阴性杆菌可有效鉴定到种，20株(26.7%)革兰阳性球菌和3株(4.5%)革兰阴性杆菌可有效鉴定到属。根据药敏试验结果判断标准，革兰阳性球菌和革兰阴性杆菌快速法与传统法药敏试验可接受标准符合率均≥90.0%，一般错误率均≤10.0%，严重错误率除复方新诺明外均≤3.0%，极严重错误率均≤1.5%。结论 快速法可有效缩短鉴定和药敏试验的时间且鉴定结果准确，有助于临床医师明确诊断并及时调整治疗方案，迅速从经验性使用广谱抗菌药物转向靶向治疗，为患者提供更加有效的治疗方案。

血流感染  /  快速鉴定  /  传统鉴定  /  药敏鉴定

Objective To compare the consistency and accuracy between rapid direct detection method (rapid method)and traditional detection method (traditional method) for bacterial identification and drug sensitivity test of positive blood culture specimens. Methods The bloodstream infection specimens of the outpatients, emergency patients and inpatients of the Chinese PLA General Hospital from 2019 to 2020 were collected and placed in a blood culture apparatus. After the blood culture alarm, positive blood culture specimens were collected. At the same time, the rapid method and the traditional method were used for culture. After culture, bacteria identification and drug susceptibility test were conducted respectively, and the consistency of bacteria identification and drug susceptibility test between the two methods was recorded and compared. Results Among the 149 positive blood specimens from patients with bloodstream infection, 79 strains of Gram-positive cocci and 70 strains of Gram-negative bacilli were identified by traditional method; 75 strains of Gram-positive cocci and 67 strains of Gram-negative bacilli were identified by the rapid method. Compared with the traditional method, the overall coincidence rate of the rapid method in identify bacteria was 95.3%(142/149), among which the coincidence rate of Gram-positive cocci was 94.9%(75/79), and that of Gram-negative bacilli was 95.7%(67/70). In the traditional method, 76 strains (96.2%) of Gram-positive cocci and 66 strains (94.3%) of Gram-negative bacteria can effectively identify their species; 3 strains (3.8%) of Gram-positive cocci and 4 strains (5.7%) of Gram-negative bacilli could effectively identify their genera. In the rapid method, 52 strains (69.3%) of Gram-positive cocci and 63 strains (94.0%) of Gram-negative bacilli could effectively identify their species, 20 strains (26.7%) of Gram-positive cocci and 3 strains (4.5%) of Gram-negative bacilli could effectively identify their genera. According to the criteria of drug sensitivity test results, the coincidence rates between the rapid method and the traditional method for drug sensitivity test of Gram-positive cocci and Gram-negative bacilli were more than or equal to 90.0%, the general error rates were less than 10.0%, the serious error rates were less than 3.0%except compound sulfamethoxazole, and the extremely serious error rates were less than 1.5%. Conclusion The rapid method can effectively shorten the time of identification and drug sensitivity test, and the identification results are accurate. It is helpful for clinicians to make a clear diagnosis and adjust the treatment plan in time, quickly shift from empirical use of broad-spectrum antibiotics to targeted treatment, and provide more effective treatment plan for patients.

bloodstream infection  /  rapid identification  /  traditional identification  /  susceptibility test
丁毅伟, 吴思敏, 韩志海. 血流感染细菌快速鉴定及药敏试验的方法学评价. 解放军医学杂志, 2021 , 46 (5) : 468 -473 . DOI: 10.11855/j.issn.0577-7402.2021.05.07
Yi-Wei Ding, Si-Min Wu, Zhi-Hai Han. Methodological evaluation of rapid identification and drug susceptibility testing of bloodstream infection bacteria[J]. Medical Journal of Chinese People’s Liberation Army, 2021 , 46 (5) : 468 -473 . DOI: 10.11855/j.issn.0577-7402.2021.05.07
正文
收起
血流感染是一种严重的全身感染性疾病，发病率较高，可导致机体多器官功能障碍，严重者发生休克甚至死亡[1]。血流感染患者的预后与有效的抗生素治疗起始时间有关，若在感染初期开始治疗，存活率为79.9%，每推迟1h存活率将降低7.6%[2]；而由于缺乏快速的细菌鉴定和药物敏感性信息，临床医师常采取经验性广谱抗生素治疗，若药物选择不恰当，会降低生存率乃至出现较高的病死率[3]。因此，快速检测血流感染中的病原菌(如细菌和真菌等)以降低微生物的抗药性，以及为临床提供快速和准确的抗菌药物敏感性试验结果，是临床微生物实验室需要解决的重要问题[4-5]。本研究对血培养阳性标本行MALDI-TOF MS鉴定和VITEK 2 Compact药敏试验，比较快速直接检测方法(简称快速法)与传统检测方法(简称传统法)的一致性及准确性，以期对血流感染病原体快速鉴定及药敏试验的方法学做出评价。
1 材料与方法
收起
1.1 标本及其来源
采集2019—2020年解放军总医院第六医学中心门急诊及住院患者的血流感染标本，按照《临床微生物实验室血培养操作规范卫生行业标准(WS/T503-2017)》进行血培养采集标准操作，送至检验科，置于血培养仪中培养，待血培养报警后收集阳性标本。
1.2 主要试剂及仪器
血琼脂培养基、麦康凯琼脂培养基(郑州安图生物工程股份有限公司)；HB&L微生物培养仪(意大利Alifax HB&L公司)；基质辅助激光解吸电离飞行时间质谱仪(MALDI-TOF MS)(美国Bruker-Daltonik公司)；VITEK 2 Compact型全自动微生物鉴定和药敏系统(法国梅里埃公司)。
1.3 快速法与传统法鉴定试验
1.3.1 快速法鉴定试验
取2 ml血培养阳性标本置于1.5 ml无菌EP管中，然后从EP管中取10 μl菌液转种于2 ml HB&L细菌分析仪培养液瓶中，置于HB&L微生物培养仪中进行继代培养，当菌液浓度达到1.5麦氏浓度后，取1 ml阳性菌液置于1.5 ml无菌EP管中，13 000 r/min离心3 min，制备沉淀物。平行制备2份沉淀物，利用MALDI-TOF MS鉴定细菌。
1.3.2 传统法鉴定试验
将收集的血培养阳性标本进行传统法培养，接种于血平板培养基、麦康凯培养基，35℃培养24 h后，挑取单个菌落，利用MALDI-TOF MS鉴定细菌。
1.4 快速法与传统法药敏试验
1.4.1 快速法药敏试验
当上述阳性菌液浓度达到1.5麦氏浓度后，取1 ml置于1.5 ml无菌EP管中，13 000 r/min离心2 min，制备沉淀物。平行制备2份沉淀物，利用VITEK 2 Compact全自动微生物分析系统进行药敏试验。
1.4.2 传统法药敏试验
选择培养皿上的待测菌落，利用VITEK 2 Compact全自动微生物分析系统进行药敏试验；如需K-B药敏试验，参照美国临床实验室标准化协会(CLSI)标准进行。快速法与传统法药敏试验判断折点均参照CLSI M100-S29文件。
1.5 快速法与传统法鉴定试验和药敏试验结果判读标准
MALDI-TOF MS细菌鉴定结果判读：鉴定得分≥2.000分表示准确鉴定到种，1.700~1.999分表示准确鉴定到属，<1.700分表示鉴定结果不可靠。参照ISO20776-2文件判断快速法与传统法药敏试验结果的符合率和错误率，当比对结果完全满足可接受标准时，则为可接受(表1)。
1.6 统计学处理
采用Whonet 5.6及Excel软件进行统计分析。计数资料以率(%)表示。
2 结果
收起
2.1 快速法与传统法鉴定结果一致率分析
共收集血培养阳性标本149例。如表2所示，传统法鉴定出革兰阳性球菌79株、革兰阴性杆菌70株。快速法与传统法鉴定相符的革兰阳性球菌75株、革兰阴性杆菌67株。两种方法鉴定的一致率为95.3%(142/149)，鉴定革兰阳性球菌、革兰阴性杆菌的一致率分别为94.9%(75/79)、95.7%(67/709)。
2.2 快速法与传统法鉴定革兰阳性球菌的准确性分析
如表3所示，149例血培养阳性标本中，传统法鉴定出革兰阳性球菌79株，其中76株(包括2.300~3.000分16株、2.000~2.299分60株)鉴定到种，占96.2%(76/79)；3株鉴定到属，占3.8%(3/79)。快速法鉴定出革兰阳性球菌75株，其中52株(包括2.300~3.000分10株、2.000~2.299分42株)鉴定到种，占69.3%(52/75)；20株鉴定到属，占26.7%(20/75)；3株鉴定结果不可靠，占4.0%(3/75)。
2.3 快速法与传统法鉴定革兰阴性杆菌的准确性分析
如表4所示，149例血培养阳性标本中，传统法鉴定出革兰阴性杆菌70株，其中66株(包括2.300~3.000分29株、2.000~2.999分37株)鉴定到种，占94.3%(66/70)；4株鉴定到属，占5.7%(4/70)。快速法鉴定出革兰阴性杆菌67株，其中63株(包括2.300~3.000分30株、2.000~2.999分33株)鉴定到种，占94.0%(63/67)；3株鉴定到属，占4.5%(3/67)；1株鉴定结果不可靠，占1.5%(1/67)。
2.4 革兰阳性球菌快速法与传统法药敏试验结果的符合率和错误率分析
传统法共分离出79株革兰阳性球菌，按照葡萄球菌、肠球菌、链球菌药敏试验结果符合率统计，环丙沙星、莫西沙星、呋喃妥因、利福平4种药物的一般错误率均≤10.0%。氯林霉素、四环素、复方新诺明出现严重错误，其中氯林霉素、四环素严重错误率均<3.0%，复方新诺明严重错误率为3.1%。诱导性克林霉素出现极严重错误，极严重错误率为1.5%(表5)。
2.5 革兰阴性杆菌快速法与传统法药敏试验结果的符合率和错误率分析
传统法共分离出70株革兰阴性杆菌，根据革兰阴性杆菌药物药敏试验结果符合率统计，氨苄青霉素/舒巴坦、头孢哌酮/舒巴坦、头孢吡肟、米诺环素、替加环素、美罗培南、阿米卡星、环丙沙星、左氧氟沙星的一般错误率均≤10%，未出现严重错误和极严重错误，所有药物均符合快速法和传统法的药敏试验结果判断标准(表6)。
3 讨论
收起
血流感染引起的脓毒症是住院患者尤其是重症监护室患者死亡的主要原因之一[6-7]。血培养是诊断血流感染的“金标准”，也是血流感染不可替代的确诊试验方法。近年来，细菌的多重耐药有上升趋势[8-10]，且仅少数新开发的抗生素被纳入临床治疗中[11-12]。因此，血培养阳性样品的快速鉴定和药敏试验尤为重要。
本研究结果显示，快速法与传统法鉴定的一致率为95.3%，鉴定革兰阳性球菌、革兰阴性杆菌的一致率分别为94.9%和95.7%，均高于血清分离胶法MALDI-TOF MS直接鉴定，如马坚等[13]的研究中革兰阳性球菌和革兰阴性杆菌的鉴定一致率分别为64.1%和35.9%，而李聪等[14]的研究中分别为52.9%和88.4%，Gu等[15]的研究中分别为71.0%和74.0%，分析其原因可能为快速法仅吸取10 µl样本，可减少血培养液中血液细胞、纤维等成分的干扰。本研究发现，快速法与传统法鉴定肠杆菌科具有很好的一致性，其中肺炎克雷伯菌、大肠埃希菌、产气肠杆菌、黏质沙雷菌、阴沟肠杆菌能够全部被鉴定出，但1株铜绿假单胞菌和2株洋葱伯克霍尔德菌等革兰阴性杆菌未鉴定出，金黄色葡萄球菌、头葡萄球菌、科氏葡萄球菌、表皮葡萄球菌等革兰阳性球菌各1株未鉴定出。分析其原因可能是由于非发酵菌代谢较慢，获取的菌液沉淀不足以达到MALDI-TOF MS分析的阈值，从而影响了鉴定结果，后期应加大样本量进一步分析。
本研究采用MALDI-TOF MS鉴定病原菌，共分为2.300~3.000、2.000~2.299、1.700~1.999、<1.700 4个分值段，一般认为分值≥2.000分为鉴定到种，1.700~1.999分为鉴定到属，<1.700分为鉴定结果不可靠。快速法鉴定革兰阳性球菌≥1.700分72株，占91.1%(72/79)，鉴定革兰阴性杆菌≥1.700分66株，占94.3%(66/70)，菌属鉴定率达90.0%以上。传统法与快速法鉴定的分值主要集中在2.000~2.299分，其中传统法鉴定出的革兰阳性球菌占75.9%(60/79)，快速法鉴定出的革兰阳性球菌占56.0%(42/75)，且快速法鉴定分值在2.300~3.000分占比达13.3%(10/75)。本研究还发现，传统法未见鉴定分值<1.700分的菌株，但快速法中革兰阳性球菌鉴定分值<1.700分占4.0%(3/75)，革兰阴性球菌鉴定分值<1.700分占1.5%(1/67)。有学者建议在不影响准确性的情况下，鉴定分值最低可降至1.4分[16-18]。因此，快速法可快速获得细菌鉴定结果，直接为临床医师提供参考意见，必要时可针对目标菌经验用药，尽早为患者提供有效治疗。
目前，传统法血培养报阳后，进行细菌药物敏感试验用时长，通常需要48~72 h才可获得准确结果，难以满足临床及时获取感染病原菌及其药敏试验结果的需求。而快速法可缩短药敏试验时间，且能提供准确的药敏试验结果。本研究发现，革兰阴性杆菌药敏试验中，美罗培南、环丙沙星、左氧氟沙星、头孢哌酮/舒巴坦、头孢吡肟、替加环素、阿米卡星、氨苄西林/舒巴坦、米诺环素的药敏结果标准符合率≥90%、一般错误率≤10%，未出现严重错误和极严重错误；革兰阳性球菌药敏试验中，氯林霉素、四环素出现严重错误，诱导性克林霉素出现极严重错误，但均符合标准，值得注意的是复方新诺明药敏结果出现严重错误，严重错误率为3.1%，超出标准，后期应加大样本量进一步分析原因。该结果与Barnini等[17]的研究一致：革兰阴性杆菌和革兰阳性球菌在所有药物检测中的准确性可达90%以上。本研究采用HB&L微生物培养仪联合MALDI-TOF MS及VITEK 2 Compact仪器进行细菌鉴定和药敏试验，可有效缩短菌株鉴定及药敏试验的时间，且能达到一定的准确性。值得注意的是，本研究对于鉴定时间未进行具体分析，且测试的菌株数量较少，后续仍需收集更多临床标本进一步评估。
综上所述，本研究采用HB&L微生物培养仪对快速培养阳性标本行直接鉴定和药敏试验，突破传统培养后应用单个菌落进行菌种鉴定和药敏试验的局限，避免了血培养阳性标本血液直接鉴定时血细胞引起的干扰，且可节省约24 h的培养时间，缩短了检测周转时间，具有一定的技术创新性，可为临床血流感染的及时诊断和治疗提供实验室依据，具有较高的临床应用价值。该方法可帮助临床医师及时明确血流感染的病原菌，使医师从经验性使用广谱抗菌药物快速转变为有针对性的靶向治疗，降低了药物毒性、耐药性和医疗成本，从而提高临床抗感染治疗的效果。
基金
收起
  • 解放军总医院第六医学中心创新培育基金(CXPY201915)
  • 军队后勤科研面上项目(CLB20J019)
文献
收起
参考文献 引证文献
排序方式：
[1]
Ma YT, Yang M, Zhang KX, et al. Mass spectrometry of serum polypeptides of enterococcus faecium bloodstream infection in mice[J]. Med J Chin PLA, 2019, 44(11): 925-930.
[麻雅婷, 杨明, 张可昕, 等. 小鼠屎肠球菌血流感染的血清多肽质谱分析[J]. 解放军医学杂志, 2019, 44(11): 925-930.]
[2]
Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock[J]. Crit Care Med, 2006, 34(6): 1589-1596.
[3]
Kumar A, Ellis P, Arabi Y, et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock[J]. Chest, 2009, 136(5): 1237-1248.
[4]
Meda M, Clayton J, Varghese R, et al. What are the critical steps in processing blood cultures? A prospective audit evaluating current practice of reporting blood cultures in a centralised laboratory serving secondary care hospitals[J]. J Clin Pathol, 2017, 70(4): 361-366.
[5]
Hayakawa K, Mezaki K, KobayakawA M, et al. Impact of rapid identification of positive blood cultures using the Verigene system on antibiotic prescriptions: A prospective study of community-onset bacteremia in a tertiary hospital in Japan[J]. PLoS One, 2017, 12(7): e0181548.
[6]
Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock(sepsis-3)[J]. JAMA, 2016, 315(8): 801-810.
[7]
Wei W, Zhao HS, Ding HS, et al. Serum procalcitonin, peroxiredoxin-4 and high mobility group box-1 levels in sepsis patients with bloodstream infection and their influence on prognosis[J]. Trauma and Critical Care Medicine, 2020, 8(6): 469-470, 473.
[魏威, 赵宏胜, 丁宏胜, 等. 血流感染致脓毒症患者血清降钙素原、过氧化物还原酶4、高迁移率族蛋白 B1水平及其对预后影响[J]. 创伤与急危重病医学, 2020, 8(6): 469-470, 473.]
[8]
Ferrer R, Martin-loeches I, Phillips G, et al. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement proGram[J]. Crit Care Med, 2014, 42(8): 1749-1755.
[9]
Retamar P, Portillo MM, López-prieto MD, et al. Impact of inadequate empirical therapy on the mortality of patients with bloodstream infections: A propensity score based analysis[J]. Antimicrob Agents Chemother, 2014, 56(1): 472-478.
[10]
Chen HC, Lin WL, Lin CC, et al. Outcome of inadequate empirical antibiotic therapy in emergency department patients with community-onset bloodstream infections[J]. J Antimicrob Chemother, 2013, 68(4): 947-953.
[11]
Liscio JL, Mahoney MV, Hirsch EB. Ceftolozane/tazobactam and ceftazidime/avibactam: Two novel β-lactam/β-lactamase inhibitor combination agents for the treatment of resistant Gram-negative bacterial infections[J]. Int J Antimicrob Agents, 2015, 46(3): 266-271.
[12]
Sharma R, Francois D, Hammerschlag MR. New antimicrobial agents for the treatment of staphylococcal infections in children[J]. Pediatr Clin North Am, 2017, 64(6): 1369-1387.
[13]
Ma J, Yu WJ, Hu BJ, et al. Rapid method for direct identification of bacteria in blood culture broth using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry[J]. Chin J Nosocomiol, 2017, 27(12): 2676-2679.
[马坚, 俞万钧, 胡必杰, 等. 通过基质辅助激光解析电离飞行时间质谱系统直接快速鉴定阳性血培养[J]. 中华医院感染学杂志, 2017, 27(12): 2676-2679.]
[14]
Li C, Ding SF, Huang Y, et al. VITEK-MS direct identification of bacteria from positive BacT/ALERT 3D blood culture bottles[J]. Chin J Nosocomiol, 2017, 26(23): 13-17.
[李聪, 丁守甫, 黄颖, 等. VITEK-MS质谱仪直接检测BacT/ALERT 3D仪阳性血培养瓶微生物的实验研究[J]. 中华医院感染学杂志, 2017, 26(23): 13-17.]
[15]
Gu YF, Li Y, Zhang XL, et al. A new method aimed to quickly identify pathogen and drug susceptibility test based on matrix-assisted laser desorption/ionization time of flight mass spectrometry combined with flow cytometry[J]. Surg Infect(Larchmt), 2019, 20(3): 219-224.
[16]
Saffert RT, Cunningham SA, Mandrekar J, et al. Comparison of three preparatory methods for detection of bacteremia by MALDI-TOF mass spectrometry[J]. Diagn Microbiol Infect Dis, 2012, 73(1): 21-26.
[17]
Barnini S, Brucculeri V, Morici P, et al. A new rapid method for direct antimicrobial susceptibility testing of bacteria from positive blood cultures[J]. BMC Microbiol, 2016, 16(1): 185.
[18]
Oberhettinger P, Zieger J, Autenrieth I, et al. Correction to: Evaluation of two rapid molecular test systems to establish an algorithm for fast identification of bacterial pathogens from positive blood cultures[J]. Eur J Clin Microbiol Infect Dis, 2020, 39(10): 2003.
2021年第46卷第5期
PDF下载
158
69
引用本文
BibTeX
文章信息
doi: 10.11855/j.issn.0577-7402.2021.05.07
  • 接收时间：2020-12-25
  • 首发时间：2025-12-24
  • 出版时间：2021-05-28
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期：2020-12-25
  • 修回日期：2021-04-01
基金
Innovation and Cultivation Fund of the Sixth Medical Center of Chinese PLA General Hospital(CXPY201915)
解放军总医院第六医学中心创新培育基金(CXPY201915)
General Research Project of Military Logistics(CLB20J019)
军队后勤科研面上项目(CLB20J019)
作者信息
    1解放军总医院第六医学中心呼吸与危重症医学科，北京 100048
    2海南省肿瘤医院病理科，海口 570312

通讯作者:

韩志海，E-mail：
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/10.11855/j.issn.0577-7402.2021.05.07
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
相关链接
论文
最新文章
热读文章
热点专题
内参
蓝皮书
产业发展报告
传播力报告
期刊分级目录
资讯
学术新闻
行业新闻
学术会议
行业会议
关于
关于我们
联系我们
北京市海淀区学院南路86号
100081
010-62199257
qkjq@cast.org.cn

中国科学技术协会版权所有 京ICP 备10216604号-4 海淀分局备案 1101084647
科技导报社主办 中国科协信息中心技术支持