c Key words: cultivation of blood, two-sets blood culture, detection rate of germ Vol. 18 No

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1 ) 1) 2) 3) 4) 1) 1) 1) 1) 1), 2) 1) 2) 3) / 4) (CNS), Bacillus c 2 p CNS Key words: cultivation of blood, two-sets blood culture, detection rate of germ ( ) 30 1 TEL: FAX: tanimichi.yumiko@nihon-u.ac.jp 1) 2 2) 3) Vol. 18 No

2 ,928 3,580 20,348 (BD) BACTEC BD 92F 93F F (BD) , ,988 1) ) A E 5 3 (CNS), Bacillus 6 26 Vol. 18 No

3 ,228 1,591 2, ) c 2 p ) CNS, Bacillus c 2 p ,320 1,788 1,505 5, ,228 1,591 2,169 4, , c E ) 240 Escherichia coli 88 (36.7 ) Klebsiella spp. 75 (31.3 ) Enterobacter spp. 39 (16.3 ), Serratia spp. 20 (8.3 ) 18 (7.5 ) 2 1 A B ) 93 Pseudomonas aeruginosa 67 (72.0 ), Acinetobacter spp. 9 (9.7 ), Stenotrophomonas maltophilia 7 (7.5 ), 10 (10.8 ) A, C A 41.9 Vol. 18 No

4 , , (3.71) 240 (4.80) 55 (0.98) 93 (1.86) 168 (2.99) 171 (3.26) CNS 172 (3.06) 319 (6.38) 72 (1.28) 95 (1.90) 27 (0.77) 35 (1.14) 28 (0.50) 30 (0.60) Bacillus 32 (0.57) 83 (1.66) 34 (0.61) 48 (0.96) 796 (14.18) 1,114 (22.33) Propionibacterium 3 6 3) 173 MRSA 121 (69.9 ), MSSA 52 (30.1 ) MRSA MSSA 4) CNS 319 Staphylococcus epidermidis 209 (65.5 ), S. epidermidis CNS 110 (34.5 ) 2 1 A B 74.3 S. epidermidis CNS 1 A ) 95 Enterococcus spp. 51 Viridans streptococci 22 Streptococcus pneumoniae E 50.5 Enterococcus 28 Vol. 18 No

5 2 249 spp. 35.3, Viridans streptococci 53.8 S. pneumoniae 68.2 E 6) Bacillus A ) ml 10 5) 6, 7) 2 CNS Bacillus 2 CNS 80 1) 8) 1) 2 1 CNS 9) CNS Bacillus Bacillus cereus 10), 11) (11.2 ) CNS Bacillus 12) 2 1), 13), 14) 2 Vol. 18 No

6 250 1) Weinstein M. P., M. L., Towns, S. M. Quartey, et al The clinical significance of positive blood cultures in the 1990s: A prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin. Infect. Dis. 24: ) BD/ BD ) (1). 46: ) The Current Clinical Technologist 1(1): ) Henny, N. K., et al Microbiological and clinical evaluation of the isolator lysis centrifugation blood culture tube. J. Clin. Microbiol. 17: ) : ) Febrile neutropenia 19(6): ) : ) coagulase-negative staphylococci 14: ) : ) Bacillus cereus 1 17: ) : ) Washington J. A., Blood cultures. Principles and techniques. Mayo. Clin. Proc. 50: ) : Increasing two-sets blood cultures and its e$cacy Yumiko Tanimichi, Michiko Yagoshi, Mitsuru Yanai, Yuki Uehara, Naoto Hosokawa, Kazuo Shimoguchi, Hiroko Yamada, Mutsuko Oosoko, Sachiyo Yamamoto, Kazunari Kumasaka 1) Clinical Laboratory Nihon University Itabashi Hospital 2) Department of Laboratory Medicine, Nihon University School of Medicine 3) Department of Infection Control Science, Faculty of Medicine, Juntendo University 4) Department of Infectious Disease, Kameda General Hospital Importance of multi-sets blood cultures is indicated so as to increase the positivity rate and help clinical judgment. But in Japan, the importance has not been recognized yet because multiple sets of blood cultures are troublesome and induce an increase in costs. In our hospital, we have encouraged to take two sets of blood cultures. As a result, the percentage of two-sets blood cultures increased from 21.0 in 2001 to 59.0 in The total positivity rate of two-sets blood cultures (22.1 ) was significantly higher than that of one-set blood culture (14.0, p 0.01). Regarding the isolates, only one of two sets showed positive results in 31.3 of the family Enterobacteriaceae, 41.9 of Non-fermentative Gram-negative rods and 21.4 of Staphylococcus aureus, which should be the pathogens of bacteremia when they are isolated in blood cultures. On the other hand, coagulase-negative Staphylococci, which is frequently recognized as 30 Vol. 18 No

7 2 251 contamination, 74.8 was positive in only one of two sets. In conclusion, two-sets blood cultures are useful to increase the positivity rate of blood culture significantly. Large percentage of essential pathogens can be detected by only one of two sets, and they also help for the interpretation of positive results of coagulase-negataive Staphylococci usually recognized as contaminant. Vol. 18 No

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