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분야
ppt2.S.epticemia (패혈증), bacteremia (균혈증)의 진단
3.균혈증 : 지속적, 간헐적, 일시적 감염
4.검사방법
5.검사주기 : 발병 후 즉시, 30분 간격
6.검사회수 : 좌우 혹은 상하의 채혈, 카테터 채혈
7.호기성과 혐기성 배양병 모두 사용
8.채혈량 : 5~10 mL / 병
9.무균적 채혈
10.피부오염균 방지 : Bacillus spp. CNS, Corynebacterium spp. Propionibacterium acnes
11.오염률 : 3% 미만을 유지해야 함
산소성 배양병 : BHI 45 mL + Blood 5 mL
무산소성 배양병 : Thioglycolate broth 45 mL
배양 2일 째, 5일째에 무조건 계대배양 (맹검배양, blind culture)
자동화 장비 사용
BACTEC : 혈액 8-10 mL
표준배양병
Bead가 첨가된 병 (혈액내 항균제 제거)
BacT/ALERT : 혈액 8-10 mL
표준배양볍
Charcole이 첨가된 병(혈액내 항균제 제거)
BacT/Alert FA (AEROBIC)
75cc plastic bottle
30 mL Brain Heart Infusion broth supplemented with pyridoxine HCI, menadione, hemin and additional complex amino acids and carbohydrate substrates
Supplemented with activated charcol, for removal of toxic components which might be present in blood and media(in blood : e.g.antibiotic, complement, lysozyme, transferring, r-globulin’s: in media: peroxide)
Containsanticoagulant : 0.05% sodium polyanethole sulfonate(SPS)
Contains an atmosphere of O2 under vacuum
Green plastic flip top and color-coded label
Recommended fill 0.5-10 mL
BacT/Alert FN (ANAEROBIC)
75cc plastic bottle
40 mL Brain Heart Infusion broth supplemented with activated charcol
Contains anticoagulant : 0.05% sodium polyanethole sulfonate(SPS)
Contains an atmosphere of O2 under in nitrogen
Orange plastic flip top and color-coded label
Recommended fill 0.5-10 mL
BacT/Alert PF (PEDIATRIC)
75cc plastic bottle
20 mL Brain Heart Infusion broth supplemented with hemin, menadione and pyridoxine
Containsanticoagulant : 0.02% sodium polyanethole sulfonate(SPS)
Contains an atmosphere of CO2 under in vaccum
Yellow plastic flip top and color-coded label
Maximum fill 0.5-10 mL
채혈 지침
1회 채혈량 : 20 ~ 30 mL (CLSI 지침) 병당 채혈량보다 1회 검사량이 더 중요.
발열 중인 환자에서 24시간 내에 2-3회, 30-1시간 간격 채혈
항균제 투여전 채혈, 투여중인 환자는 48시간 내 6회 이상
EDTA, heparin, citrate 항응고제 사용 금지
SPS를 항응고제로 사용 (배지에 포함)
