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从急诊科新建立的静脉导管中采集血培养不会增加血培养污染的发生率。

Taking blood cultures from a newly established intravenous catheter in the emergency department does not increase the rate of contaminated blood cultures.

机构信息

Joseph Epstein Centre for Emergency Medicine Research at Western Health, Sunshine Hospital, Melbourne, Victoria, Australia.

出版信息

Emerg Med Australas. 2013 Oct;25(5):435-8. doi: 10.1111/1742-6723.12121. Epub 2013 Sep 9.

Abstract

OBJECTIVE

It has been suggested that blood cultures drawn from vascular catheters have a higher false positive rate than those drawn by venepuncture. In the face of institutionally imposed practice change prohibiting obtaining blood cultures from intravenous (i.v.) catheters in the ED, our aim of was to compare the rate of contaminated blood cultures between those taken from recently placed i.v. catheters and those taken by direct venepuncture.

METHOD

Prospective, non-randomised, observational study comparing the rate of contaminated blood cultures for specimens taken from recently placed (<1 h) i.v. catheters and direct venepuncture in adult ED patients. Outcome of interest was the rate of false positive cultures. Analysis was by comparison of proportions (χ(2) -test).

RESULTS

Four hundred seventy-two blood culture sets were studied. There were 65 positive cultures, of which 49 (75%; 95% confidence interval [CI], 63-85%) were classified as true positive. The overall rate of contaminated blood cultures was 3.4% (95% CI, 2.0-5.6%). There was no difference in false positive rate between blood cultures taken via venepuncture and those taken from a recently placed i.v. cannula (P = 0.52; odds ratio, 0.9; 95% CI, 0.33-2.44).

CONCLUSION

We found no difference in contaminated blood culture rate between recently placed i.v. catheters and direct venepuncture when infection control procedures were followed.

摘要

目的

有研究表明,与静脉穿刺采血相比,从血管导管中采集的血培养物假阳性率更高。在机构强制实施的实践改变下,禁止在急诊科从静脉内(IV)导管获取血培养物,我们的目的是比较最近放置的 IV 导管和直接静脉穿刺采集的血培养物的污染率。

方法

这是一项前瞻性、非随机、观察性研究,比较了最近放置(<1 小时)的 IV 导管和成人急诊科患者直接静脉穿刺采集的血培养标本的污染率。感兴趣的结果是假阳性培养物的比例。分析采用比例比较(χ(2)检验)。

结果

共研究了 472 组血培养。有 65 个阳性培养物,其中 49 个(75%;95%置信区间 [CI],63-85%)被归类为真阳性。总的血培养污染率为 3.4%(95%CI,2.0-5.6%)。静脉穿刺和最近放置的 IV 导管采集的血培养物的假阳性率没有差异(P=0.52;比值比,0.9;95%CI,0.33-2.44)。

结论

我们发现,在遵循感染控制程序的情况下,最近放置的 IV 导管与直接静脉穿刺采集的血培养物的污染率没有差异。

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