血培养中的质量保证：尼日利亚一家三级医院血培养污染率的回顾性研究。
Quality assurance in blood culture: A retrospective study of blood culture contamination rate in a tertiary hospital in Nigeria.
作者信息
Chukwuemeka Iregbu Kenneth, Samuel Yakubu
机构信息
Department of Medical Microbiology and Parasitology, National Hospital Abuja, Abuja, Nigeria.
出版信息
Niger Med J. 2014 May;55(3):201-3. doi: 10.4103/0300-1652.132038.
BACKGROUND
Blood culture is a critical tool for diagnosing septicaemia. Quite frequently, contamination of blood sample poses a great challenge to accurate diagnosis. This study evaluated the rate of blood culture contamination in our hospital over a one-year period.
MATERIALS AND METHODS
It was a retrospective study of 1032 blood cultures carried out in a clinical laboratory of a tertiary hospital in North Central part of Nigeria between 2010 and 2011.
RESULTS
There were 730 blood cultures from paediatric and 302 adult patients. The overall yield was 22%; 107 out of the 730 were contaminated giving a contamination rate of 10.4%. Contamination rate was higher in children than in adult (11% vs 8%) specimen. These rates were much higher than the acceptable benchmark of 2-3%. The main contaminants were coagulase negative Staphylococcus, Bacillus species, Diphtheroids and Enterococcus species.
CONCLUSION
Contamination rate is high, and mainly due to normal skin flora, suggesting aseptic collection challenges as the main cause. We recommend a review of the entire process of blood collection for culture and analysis with a view to instituting appropriate quality assurance measures to reduce the contamination rate.
背景
血培养是诊断败血症的关键工具。血液样本污染经常给准确诊断带来巨大挑战。本研究评估了我院一年期间血培养的污染率。
材料与方法
这是一项对2010年至2011年在尼日利亚中北部一家三级医院临床实验室进行的1032次血培养的回顾性研究。
结果
有730次血培养来自儿科患者，302次来自成人患者。总体阳性率为22%；730次中有107次被污染，污染率为10.4%。儿童标本的污染率高于成人（11%对8%）。这些比率远高于2 - 3%的可接受基准。主要污染物为凝固酶阴性葡萄球菌、芽孢杆菌属、类白喉杆菌和肠球菌属。
结论
污染率很高，主要是由于正常皮肤菌群，这表明无菌采集存在挑战是主要原因。我们建议对血培养采集的整个过程进行审查并分析，以便制定适当的质量保证措施以降低污染率。
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