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血培养假阳性结果的财务和临床影响。

Financial and clinical impact of false-positive blood culture results.

作者信息

Waltzman M L, Harper M

机构信息

Division of Emergency Medicine, Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA.

出版信息

Clin Infect Dis. 2001 Aug 1;33(3):296-9. doi: 10.1086/321881. Epub 2001 Jun 21.

Abstract

During a 4-year period, 9465 specimens for blood culture were obtained from 11,911 highly febrile, otherwise healthy young children. Of these specimens, 87 (0.9%) yielded nonpathogens and were considered to be false-positive blood culture results (FPBCRs). Seventy-two of the patients who provided these specimens were treated on an outpatient basis (resulting in $10,821 in treatment charges), and 7 were admitted to the hospital (resulting in $16,200 in charges) as a result of the FPBCRs. Studies performed during follow-up included a second blood culture (21 patients), complete blood cell count (11), urine analysis and culture (5), lumbar puncture (3), and chest radiography (3). Only a small minority of patients were hospitalized or underwent invasive procedures. The charges associated with FPBCRs are very small in comparison to the initial charges of culturing specimens obtained from children considered to be at risk. Concern about the consequences of FPBCRs should not deter clinicians from performing indicated cultures for children who potentially have bacteremia.

摘要

在4年期间,从11911名高热但其他方面健康的幼儿中采集了9465份血培养标本。在这些标本中,87份(0.9%)培养出非病原体,被视为血培养假阳性结果(FPBCRs)。提供这些标本的患者中,72人接受门诊治疗(产生治疗费用10821美元),7人因FPBCRs住院(产生费用16200美元)。随访期间进行的检查包括第二次血培养(21例患者)、全血细胞计数(11例)、尿液分析和培养(5例)、腰椎穿刺(3例)及胸部X线检查(3例)。只有极少数患者住院或接受侵入性检查。与FPBCRs相关的费用与从被认为有风险的儿童中采集标本进行培养的初始费用相比非常少。对FPBCRs后果的担忧不应阻止临床医生对可能患有菌血症的儿童进行必要的培养。

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