血培养是诊断血流感染的重要手段.根据国内一项荟萃分析结果显示, 我国普通病房住院患者血流感染病死率为20.7％,烧伤、血液病、恶性肿瘤和重症监护室的患者病死率可达30.3％～46.5％[1].近年来,随着创伤性诊疗技术的广泛开展以及广谱抗生素、激素的广泛应用,血流感染的发病率呈现不断的上升趋势. 因此血培养也越来越受到人们的重视,不止在三甲医院,甚至在县、市级医院血培养也被大力地推广和使用.各种品牌、各种功能的血培养瓶应运而生,在诸多的产品中如何选择一款适合自己实验室的产品需要综合考虑多方面的因素,其中最核心的就是产品性能. 本研究就目前市场上主要的血培养瓶生产商美国BD公司、 法国梅里埃公司及郑州安图生物工程有限公司的需氧瓶、儿童瓶及厌氧瓶性能进行验证分析,为临床实验室选择产品,厂商改进产品质量提供参考和实验依据,现报道如下.

With increasing use of carbapenem antibiotics , carbapenems-resistant gram-negative bacteria are spreading, and carbapenemase-producing is the main mechanism of carbapenems resistance . Rapid and accurate identification of carbapenemase and its type is of great importance to timely and effective treatment and control of infections .Chromogenic /Fluorogenic culture media, modified Hodge test and double disk synergy test are traditional methods for carbapenemase detection , but all are time-consuming. Biochemical method is more time efficient and with high sensitivity and specificity , but cannot be used to identify subtypes.Now matrix-assisted laser desorption ionization -time-of-flight mass spectrometry (MALDI-TOF MS) has been successfully applied in the identification of species , subtypes and detection of drug -resistant genes.And among various carbapenemase gene detection techniques , next generation sequencing (NGS) can also be used for the detection of integrons , transposons and plasmids, which is important in both epidemiology and resistant mechanism studies .This article reviews the advantages and disadvantages of various methods for phenotype and gene detection of carbapenemase .

Objective To study the possibility of direct identification of pathogens from positive blood cul-tures by methods of separation gel tube -centrifugation.Methods 216 cases of positive blood culture were collected from 2015.7 to 2015.12.The bacterias were purified from blood culture bottle by separation gel tube.After washing 2 times,identified by MALDI -TOF MS.At the same time,traditional culture,smears and identification were done. Compared the results of identification by two methods.Results 216 cases of positive blood culture were single bacte-rial infection.By Gram stain,89 strains were Gram positive,119 strains were Gram negative and 8 strains were fungal spores.190 cases of positive blood culture were identified by MALDI -TOF MS,it concluded 67 Gram positive strains,111 Gram negative strains,4 anaerobe strains and 8 fungus.Compared with traditional culture,the coincidence rate reached up to 87.9%,Gram positive strains 78.8%,Gram negative strains 93.2%,anaerobe strains 100.0%and fungus 100.0%.Conclusion It takes less than 30 minutes purified from blood culture bottle by separation gel tube.And the time of identification is shorter than traditional culture.This method is good for clinical diagnosis and treatment.