Stevenson Anna, Hider Phil, Than Martin
Clinical Decision Support Unit, Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand.
N Z Med J. 2005 Mar 11;118(1211):U1351.
To assess the utility of blood cultures in the management of patients presenting to the Emergency Department at Christchurch Hospital from the community with non-facial cellulitis (or soft tissue infection) and no other morbidity.
A multidisciplinary team formulated the search protocol. A systematic review methodology was used. Seven electronic databases were searched for clinical studies of blood culture utility in patients with non-facial cellulitis. Relevant studies were appraised using predetermined validity assessment criteria. Conclusions were presented based on an assessment of the validity and applicability of the evidence.
Seventeen studies were identified as addressing the topic at least as part of a secondary objective for the study. All were retrospective reviews or case series and were often associated with significant methodological limitations.
Blood cultures are rarely positive in patients presenting from the community with non-facial cellulitis. When they are positive, initial empiric therapy is usually adequate to treat pathogenic bacteria. The available evidence does not support the routine use of blood cultures in the clinical management of healthy adults presenting with non-facial cellulitis at the Emergency Department.
评估血培养在克赖斯特彻奇医院急诊科接诊的来自社区的非面部蜂窝织炎（或软组织感染）且无其他疾病的患者管理中的作用。
一个多学科团队制定了检索方案。采用系统评价方法。检索了七个电子数据库，以查找非面部蜂窝织炎患者血培养作用的临床研究。使用预先确定的有效性评估标准对相关研究进行评估。基于对证据有效性和适用性的评估得出结论。
十七项研究被确定至少作为研究的次要目标涉及该主题。所有研究均为回顾性综述或病例系列，且常常存在显著的方法学局限性。
来自社区的非面部蜂窝织炎患者血培养很少呈阳性。当血培养呈阳性时，初始经验性治疗通常足以治疗病原菌。现有证据不支持在急诊科对无其他疾病的非面部蜂窝织炎健康成人进行临床管理时常规使用血培养。
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