Department of Microbiology, Great Western Hospital, Swindon, UK.
J Hosp Infect. 2014 May;87(1):1-10. doi: 10.1016/j.jhin.2014.02.009. Epub 2014 Mar 26.
Blood cultures are an essential diagnostic tool. However, contamination may impact on patients' care and lead to increased patient stay, additional tests, and inappropriate antibiotic use. The aim of this study was to review the literature for factors that influence the rate of blood culture contamination. A comprehensive literature search was performed using Medline and CINAHL on blood culture contamination. Hospitals/units should have in place a protocol for staff on how to take blood cultures, incorporating use of an aseptic technique. Studies have shown that several key factors in the process may lower contamination rates such as adherence to a protocol, sampling by peripheral venepuncture route rather than via an intravascular catheter, use of sterile gloves, cleaning tops of blood culture bottles with antiseptics and inoculating blood culture bottles before other blood tubes, samples being taken by a phlebotomy team, monitoring contamination rates, and providing individual feedback and retraining for those with contaminants. Although skin antisepsis is advocated there is still debate on which antiseptic is most effective, as there is no conclusive evidence, only that there is benefit from alcohol-containing preparations. In conclusion, hospitals should aim to minimize their blood culture contamination rates. They should monitor their rate regularly and aim for a rate of ≤3%.
血培养是一种重要的诊断工具。然而，污染可能会影响患者的治疗，并导致患者住院时间延长、额外的检查和不适当的抗生素使用。本研究旨在回顾影响血培养污染率的因素的文献。使用 Medline 和 CINAHL 对血培养污染进行了全面的文献检索。医院/单位应制定一项工作人员采集血培养的规程，包括使用无菌技术。研究表明，在该过程中的几个关键因素可能会降低污染率，例如遵循规程、通过外周静脉穿刺而不是通过血管内导管进行采样、使用无菌手套、用消毒剂清洁血培养瓶的顶部并在其他血液管之前接种血培养瓶、由采血团队采集样本、监测污染率，并为有污染的人员提供个人反馈和再培训。尽管提倡皮肤消毒，但仍存在关于哪种消毒剂最有效的争论，因为没有确凿的证据，只有含酒精制剂有好处。总之，医院应努力将血培养污染率降至最低。他们应定期监测其污染率，并力争达到≤3%。
