妥洛尼定对血液培养物阳性反应时间的影响

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice Pub Date : 2024-02-29 DOI:10.1016/j.infpip.2024.100352

C.H. van den Bosch , J.E.P. Moree , S. Peeters , M. Lankheet , A.F.W. van der Steeg , M.H.W.A. Wijnen , M.D. van de Wetering , J.T. van der Bruggen

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引用次数: 0

摘要

背景含有妥洛尼定的锁定溶液（TL）是预防中心静脉导管相关血流感染的有效方法。由于意外情况，在进行血液培养之前，中心静脉导管 (CVC) 中的 TL 可能并不总是被吸出。TL 可能无意中进入血培养瓶，从而可能改变结果。本研究旨在探讨 TL 对检测血培养瓶中微生物生长的影响。方法在BD BACTECTM血液培养瓶（Plus Aerobic/F、Lytic/10 Anaerobic/F或Peds Plus/F）中加入不同的锁定溶液（牛磺酸肝素（TCHL）、牛磺酸肝素、肝素、柠檬酸盐或氯化钠），然后在有血和无血的情况下加入金黄色葡萄球菌（ATCC 29213或临床菌株）或大肠杆菌（ATCC 25922或临床菌株）。随后，血液培养瓶在 BD BACTEC FX 仪器中进行培养，以阳性时间（TTP）为主要结果。讨论与含有肝素、枸橼酸盐或氯化钠的培养瓶相比，在有妥洛尼定存在的情况下，TTP 明显延迟，甚至保持阴性。这种效应与剂量有关。本研究强调了在进行血液培养之前从 CVC 中丢弃 TL 的临床重要性。

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The effect of taurolidine on the time-to-positivity of blood cultures

Background

Taurolidine containing lock solutions (TL) are a promising method for the prevention of central line associated bloodstream infections. Per accident, the TL may not always be aspirated from the central venous catheter (CVC) before blood cultures are obtained. The TL could, unintentionally, end up in a blood culture vial, possibly altering the results. The aim of this study was to investigate the effect of the TLs on the detection of microbial growth in blood culture vials.

Methods

Different lock solutions (taurolidine-citrate-heparin (TCHL), taurolidine, heparin, citrate or NaCl) were added to BD BACTEC^TM blood culture vials (Plus Aerobic/F, Lytic/10 Anaerobic/F or Peds Plus/F) before spiking with Staphylococcus aureus (ATCC 29213 or a clinical strain) or Escherichia coli (ATCC 25922 or a clinical strain) in the presence and absence of blood. Subsequently, blood culture vials were incubated in the BD BACTEC FX instrument with Time-to-positivity (TTP) as primary outcome. In addition, the effect of the TCHL on a variety of other micro-organisms was tested.

Discussion

In the presence of taurolidine, the TTP was considerably delayed or vials even remained negative as compared to vials containing heparin, citrate or NaCl. This effect was dose-dependent. The delayed TTP was much less pronounced in the presence of blood, but still notable.