血培养阳性报警时间在成人凝固酶阴性葡萄球菌血流感染诊断中的意义

摘要

Objective To explore the clinical diagnostic value of time to positivity (TTP) in blood culture for the coagulase-negative Staphylococci (CoNS) blood infection in adults.Methods A retrospective analysis on data of 142 isolated CoNS strains in blood culture in hospitalized adult cases in Chinese PLA General Hospital from August 2014 to December 2015 was done.TTP was compared between bloodstream infection group and contamination group.Receiver operator characteristic curve (ROC) was used to analyze the clinical diagnostic value of TTP for CoNS blood infection in adult blood culture.Results TTP in infection group and contamination group were (24.82 ± 9.46) h vs (42.71 ± 19.11) h,respectively (P ＜ 0.01).ROC curve showed that TTP=24.90 h was the optimal cut-off point to differentiate bloodstream infection and contamination,with the area under the curve (AUC) of 0.810 (95％CI:0.740-0.880),sensitivity of 64.1％ and specificity of 87.2％.Conclusion TTP possesses a certain reference to the diagnosis of adult CoNS blood infection,which can be used as an auxiliary diagnosis marker.%目的 评价血培养阳性报警时间(time to positivity,TrP)在成人凝固酶阴性葡萄球菌(coagulase-negative Staphylococci,CoNS)血流感染诊断中的意义.方法 对本院2014年8月-2015年12月血培养中分离出CoNS的142例成年住院病例进行回顾性分析,比较TTP在血流感染组和污染组中的差异,并绘制ROC曲线,分析TrP对成人CoNS血流感染的诊断意义.结果 64例血流感染组患者和78例污染组患者的TTP分别为(24.82±9.46)h、(42.71±19.11)h,差异有统计学意义(P＜0.01).ROC曲线显示TT P=24.90 h可作为区分血流感染和污染的最佳切点,此时AUC为0.810(95％ CI为0.740～0.880),诊断灵敏度为64.1％,特异度为87.2％.结论 TTP对成人CoNS血流感染的诊断有一定参考价值,可作为一种辅助诊断指标.