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病例报告:念珠菌血症诊断过程中从发热加剧到首次使用抗真菌药物剂量的关键时间延迟分析

[Case report: Analysis of the critical time delays from the fever increase to the first antimycotic dose during the diagnosis of candidemia].

作者信息

Kappe Reinhard, Fuchs Erika, Gorges Alexander, Rimek Dagmar

机构信息

Institut für Medizinische Laboratoriumsdiagnostik und Mikrobiologie, Südharz-Krankenhaus Nordhausen gGmbH, Dr.-Robert-Koch-Strasse 39, 99734 Nordhausen.

出版信息

Mycoses. 2008 Sep;51 Suppl 3:48-51. doi: 10.1111/j.1439-0507.2008.01588.x.

Abstract

In a secondary care hospital in Germany with an in-house microbiology laboratory, an 84-year-old female patient with candidemia was selected for determination of the time periods required for each diagnostic step preceding the application of the first dose of antimycotic treatment. The total time from the beginning of fever to the first dose of fluconazole was 25 hours and 10 minutes. The largest delay occurred between the positive signal of the blood culture bottle during the night and the start of the work-up of the positive blood culture bottle in the morning. Improvements appear to be possible in both clinical and laboratory settings by optimizing pre-analytical, analytical, and post-analytical procedures.

摘要

在德国一家设有内部微生物实验室的二级护理医院,选择了一名患有念珠菌血症的84岁女性患者,以确定在应用首剂抗真菌治疗之前每个诊断步骤所需的时间段。从发热开始到首剂氟康唑给药的总时间为25小时10分钟。最大的延迟发生在夜间血培养瓶出现阳性信号与次日上午对阳性血培养瓶进行检查开始之间。通过优化分析前、分析中和分析后的程序,临床和实验室环境中似乎都有可能实现改进。

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