O'Connor C, Philip R K, Powell J, Slevin B, Quinn C, Power L, O'Connell N H, Dunne C P
Department of Clinical Microbiology, University Hospital Limerick, Ireland; Infection Prevention & Control Team, University Hospital Limerick, Ireland; Centre for Intervention in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland.
Department of Paediatrics (Division of Neonatology), University Maternity Hospital, Limerick, Ireland.
J Hosp Infect. 2016 May;93(1):105-7. doi: 10.1016/j.jhin.2016.01.011. Epub 2016 Mar 2.
Contaminated blood cultures represent challenges regarding diagnosis, duration of hospitalization, antimicrobial use, pharmacy and laboratory costs. Facing problematic neonatal blood culture contamination (3.8%), we instigated a successful intervention combining skin antisepsis using sterile applicators with 2% chlorhexidine gluconate in 70% isopropanol prior to phlebotomy (replacing 70% isopropanol) and staff education. In the six months prior to intervention, 364 neonatal peripheral blood samples were collected. Fourteen (3.8%) were contaminated. In the post-intervention six months, 314 samples were collected. Three (0.96%) were contaminated, representing significant improvement (Fisher's exact test: P = 0.0259). No dermatological sequelae were observed. The improvement has been sustained.
污染的血培养对诊断、住院时间、抗菌药物使用、药房和实验室成本构成挑战。面对新生儿血培养污染问题(3.8%),我们开展了一项成功的干预措施,即在静脉穿刺前使用无菌棉签蘸取2%葡萄糖酸氯己定的70%异丙醇溶液进行皮肤消毒(取代70%异丙醇)并对工作人员进行培训。在干预前的六个月里,共采集了364份新生儿外周血样本。其中14份(3.8%)被污染。在干预后的六个月里,共采集了314份样本。其中3份(0.96%)被污染,这代表了显著改善(Fisher精确检验:P = 0.0259)。未观察到皮肤后遗症。这种改善一直持续。