BACTEC FX40系统在成人脑膜炎病原菌鉴定中的应用

Ajay Saini, Ved Prakash, Deepika Verma, Lautika Sonkar, Saumya Agarwal, Haniya Jafar
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引用次数: 0

摘要

成人细菌性脑膜炎是一种医疗紧急情况,需要立即诊断和立即治疗。由于临床诊断并不总是可靠的,实验室分离以及抗菌药物敏感性结果至关重要。传统的琼脂培养方法灵敏度差,结果延迟。除血液培养外,BACTEC等自动化培养方法是无菌液体培养的合适选择。目的:利用BACTEC FX40全自动培养系统检测该地区脑膜炎病原菌及其抗生素谱。材料和方法:这项横断面观察性研究于2019年10月至2020年9月在印度北方邦巴雷利罗希尔坎德邦医学院和医院微生物学系进行。重症监护室(ICU)和病房采集的脑脊液(CSF)标本,先接种于BD BACTEC Peds Plus/F瓶,然后在BACTEC BD FX40系统上孵育。标记和阳性的瓶子进行传代培养,并根据标准实验室程序进一步处理。根据临床和实验室标准协会(CLSI)的指南,采用Kirby-Bauer圆盘扩散法对分离的微生物进行抗生素敏感性试验。结果:在研究期间,通过自动方法从疑似脑膜炎患者中收集了108例脑脊液进行培养。其中阳性84例(77.8%),不育24例(22.2%)。在阳性病例中,77例显示革兰氏阳性球菌生长,3例为革兰氏阴性杆菌生长,4例显示环境和皮肤污染物生长,这些均被排除在本研究之外。所有革兰氏阳性球菌鉴定为金黄色葡萄球菌(金黄色葡萄球菌)。药敏试验对万古霉素、利奈唑胺均100%敏感。仅有25株金黄色葡萄球菌对头孢西丁敏感。两株大肠杆菌均对头孢唑林、头孢他啶、氨曲南敏感。铜绿假单胞菌(P. aeruginosa)对阿米卡星和哌拉西林/他唑乳敏感。结论:细菌性脑膜炎的病原学趋势发生了变化,成人中耐甲氧西林金黄色葡萄球菌(MRSA)是最主要的分离物。发现BACTEC FX40系统在检测病原体方面比传统方法更敏感,并且缩短了阳性时间。病原微生物的早期发现将有助于尽早开始适当的抗生素治疗,从而降低死亡率和脑膜炎相关并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identification of Bacterial Agents causing Meningitis in Adult Population using BACTEC FX40 System
Introduction: Bacterial meningitis among adults is a medical emergency and requires immediate diagnosis as well as immediate treatment. As clinical diagnosis is not always reliable, laboratory isolation along with antimicrobial susceptibility results are crucial. Conventional agar culture methods gives poor sensitivity and delayed results. Automated culture methods like BACTEC are suitable option for culture of sterile fluids beside blood culture. Aim: To determine the bacterial agents causing meningitis in this region, along with their antibiogram by using automated culture system BACTEC FX40. Materials and Methods: This cross-sectional, observational study was conducted between October 2019-September 2020 in Department of Microbiology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. Cereospinal Fluid (CSF) samples received from medicine Intensive Care Unit (ICU) and wards were processed by inoculating them on BD BACTEC Peds Plus/F bottle and then incubating them on BACTEC BD FX40 system. The bottles flagged and positive were subcultured and further processed according to standard laboratory procedures. The antibiotic sensitivity test was performed from isolated organisms by Kirby-Bauer Disc Diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: A total of 108 CSF were received for culture by automated methods from patients suspected of meningitis during the study period. Out of them 84 (77.8%) beeped as positive while 24 (22.2%) were sterile. From the positives, 77 showed growth of gram positive cocci, three were gram negative bacilli and four showed growth of environmental and skin contaminants that were excluded from the study. All gram positive cocci were identified as Staphylococcus aureus (S. aureus). The antibiotic sensitivity testing showed 100% sensitivity to vancomycin and linezolid. Only 25 isolates of S. aureus were sensitive to cefoxitin. Both the isolates of Escherichia coli (E. coli) were sensitive to cefazolin, ceftazidime, aztreonam. Pseudomonas aeruginosa (P. aeruginosa) was sensitive to amikacin and piperacillin/tazobactum. Conclusion: A shift in the trend was observed in the aetiology of bacterial meningitis with Methicillin Resistant Staphylococcus aureus (MRSA) as the most predominant isolate among adult population. BACTEC FX40 system was found more sensitive in detecting pathogens over the conventional methods with reduced time to positivity. Early detection of causative organism will facilitate early initiation of suitable antibiotic therapy, thereby reducing mortality and meningitis associated complications.
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