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首页> 外文期刊>Journal of Clinical Microbiology >Controlled comparison of bioMérieux VITAL and BACTEC NR-660 systems for detection of bacteremia and fungemia in pediatric patients.
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Controlled comparison of bioMérieux VITAL and BACTEC NR-660 systems for detection of bacteremia and fungemia in pediatric patients.

机译：对照比较bioMérieuxVITAL和BACTEC NR-660系统在儿科患者中检测菌血症和真菌病的情况。

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The bioMérieux VITAL automated blood culture system measures a decrease in fluorescence to detect the presence of microorganisms in blood. To assess the performance of VITAL with AER aerobic medium versus that of the nonradiometric BACTEC NR-660 PEDS PLUS medium for the detection of sepsis in children, a total of 12,146 blood specimens were collected at three university medical centers and inoculated into AER and PEDS PLUS bottles that were weighed before and after filling. The sample volumes were considered adequate in 6,276 bottle pairs. The total yield of isolates was 629, of which 489 (78%) were judged to be the cause of true infections. Staphylococci (P < 0.001) and yeasts (P < 0.05) were detected more often in PEDS PLUS bottles, as were all microorganisms combined (P < 0.001). The improved detection in the PEDS PLUS medium was most marked for patients on antimicrobial therapy (P < 0.001), but remained statistically significant even for patients not on therapy (P < 0.025). There were 431 episodes of sepsis, including 407 considered adequate for analysis. Of the 363 unimicrobial episodes, 278 were detected by both bottles, 64 were detected by PEDS PLUS bottles only, and 21 were detected by AER bottles only (P < 0.01). No false-negative cultures were detected by terminal subculture of the PEDS PLUS bottles when the companion AER bottle was positive. However, there were 14 false-negative cultures (7 yeasts, 5 staphylococci, 1 Enterococcus faecalis, and 1 Enterobacter sp.) on terminal subculture of the AER bottles when the companion PEDS PLUS bottle was positive. When both systems were positive, the VITAL system detected bacteria earlier than did the BACTEC system by a mean of 1.6 h. Also, false-positive signals were less common with the VITAL system. We conclude that the VITAL system with AER medium must be modified to improve the detection of clinically important staphylococci and yeasts if it is to perform comparably to the BACTEC NR-660 nonradiometric system with PEDS PLUS medium for a pediatric population.
机译：bioMérieuxVITAL自动化血液培养系统可测量荧光强度的下降，以检测血液中微生物的存在。为了评估使用AER有氧培养基与非放射线BACTEC NR-660 PEDS PLUS培养基进行的VITAL检测儿童败血症的性能，在三个大学医学中心共收集了12,146份血液标本，并接种到AER和PEDS PLUS中灌装前后称重的瓶子。认为在6,276瓶对中样品量足够。分离株的总产量为629，其中489（78％）被认为是真正感染的原因。在PEDS PLUS瓶中检出葡萄球菌（P <0.001）和酵母菌（P <0.05）的频率更高，所有微生物都被检出（P <0.001）。对于使用抗生素治疗的患者，在PEDS PLUS培养基中改善的检测效果最为显着（P <0.001），但即使对于未进行治疗的患者，仍具有统计学意义（P <0.025）。败血症发作431次，其中407次被认为足以进行分析。在363次单微生物发作中，两个瓶子均检测到278个，仅PEDS PLUS瓶子检测到64个，仅AER瓶子检测到21个（P <0.01）。当配套AER瓶呈阳性时，通过PEDS PLUS瓶的末端亚培养未检测到假阴性培养。但是，当陪同的PEDS PLUS瓶呈阳性时，在AER瓶的终末传代培养中有14个假阴性培养物（7个酵母菌，5个葡萄球菌，1个粪肠球菌和1个肠杆菌属）。当两个系统均为阳性时，VITAL系统比BACTEC系统更早发现细菌1.6小时。同样，假阳性信号在VITAL系统中也较少见。我们得出的结论是，如果要与具有PEDS PLUS介质的BACTEC NR-660非辐射系统相比，适用于儿科人群，必须修改具有AER介质的VITAL系统，以提高对临床上重要的葡萄球菌和酵母菌的检测。

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