检验医学与临床2025，Vol.22Issue(14)：1909-1914,6.DOI:10.3969/j.issn.1672-9455.2025.14.008
激光散射法在儿童恶性血液病伴发血流感染病原菌快速鉴定及药敏试验中的应用探讨
Application of the light scattering technology for rapid identification and drug sensitivity testing of pathogenic bacteria associated with bloodstream infections in children with hematological malignancies
摘要
Abstract
Objective To evaluate the application value of the HB&L microbial culture system(referred to as HB&L instrument)based on laser scattering method in the rapid identification and drug sensitivity testing of pathogenic bacteria associated with bloodstream infections in children with malignant hematological malig-nancies.Methods A total of 81 positive blood culture samples from pediatric patients in Department of He-matology and Oncology in Xi'an Children's Hospital from March 2023 to March 2024 were collected.After regular cultivation and rapid cultivation using HB&L instrument,the samples were identified and subjected to drug susceptibility testing using a matrix assisted laser desorption ionization time-of-flight mass spectrometer(MALDI-TOF-MS)and VITEK-2 Compact fully automated drug sensitivity analyzer.The conventional culti-vation method was used as a reference to analyze the consistency of the pathogen identification drug suscepti-bility test results and the timeliness of the inspection report using the HB&L instrument rapid cultivation method.Results As a result,a total of 10 types of bacteria were isolated from 81 blood culture positive sam-ples,with Staphylococcus epidermidis and Escherichia coli having the highest isolation rates,with composition ratios of 20.99%(17/81)and 19.75%(16/81)respectively.The bacterial species identification rates of con-ventional culture method and the rapid cultivation using HB&L instrument were 88.89%(72/81)and 86.42%(70/81)respectively,and the genus level identification rates were 9.88%(8/81)and 8.64%(7/81)respectively,with no statistically significant differences(P>0.05).The overall classification consistency rate(CA)of the drug sensitivity test results of the rapid cultivation using HB&L instrument compared with the conventional culture was 98.14%(1 058/1 078),with 98.92%(549/555)for Gram positive bacteria and 97.32%(509/523)for Gram negative bacteria.The proportion of general error(MIE)for Gram positive bac-teria was 1.08%(6/555),with no significant error(ME)and very significant error(VME)results.The MIE composition ratio of Gram negative bacteria was 2.10%(11/523),the ME composition ratio was 0.57%(3/523),and there was no VME result,all of which were within the acceptable range.The rapid cultivation u-sing HB&L instrument had a consistent detection rate of 100.00%,100.00%and 95.65%for common bacte-rial resistance phenotypes Methicillin resistant Staphylococcus aureus,Carbapenem resistant Enterobacteriace-ae and extended spectrum beta lactase negative bacteria respectively compared with the conventional culture.Compared with convention culture,the rapid cultivation using HB&L instrument shortened the median time for bacterial identification and drug sensitivity test results release by 22.16 hours and 24.09 hours respective-ly.Conclusion The rapid cultivation method of HB&L instrument can achieve rapid subculture of pathogenic bacteria in children with malignant hematological diseases accompanied by bloodstream infections,shorten the time for identification and drug sensitivity test results reporting,and provide timely and accurate laboratory basis for the diagnosis and treatment of the disease.关键词
血流感染/恶性血液病/儿童/激光散射法/常规培养/快速培养Key words
bloodstream infection/hematological malignancy/children/light scatter technology/routine culture/rapid culture分类
医药卫生引用本文复制引用
王维,方苏,刘赛,王林..激光散射法在儿童恶性血液病伴发血流感染病原菌快速鉴定及药敏试验中的应用探讨[J].检验医学与临床,2025,22(14):1909-1914,6.基金项目
国家自然科学基金面上项目(82172312). （82172312）
