Martínez Jovanna, Macías Juan H, Arreguín Virginia, Álvarez Jose A, Macías Alejandro E, Mosqueda-Gómez Juan L
Hospital Regional de Alta Especialidad del Bajío, León, Guanajuato, Mexico.
Universidad de Guanajuato, León, Guanajuato, Mexico.
Am J Infect Control. 2017 Apr 1;45(4):350-353. doi: 10.1016/j.ajic.2016.11.027. Epub 2017 Jan 12.
False-positive blood cultures can lead to unnecessary risks and misuse of antibiotics; to reduce rates of false-positives, it would be useful to determine whether use of an antiseptic with a prolonged effect is required.
Clinical study of efficacy (blinded and randomized) to compare the rate of blood culture contamination when skin antisepsis was performed with 70% isopropyl alcohol or 2% chlorhexidine gluconate in 70% isopropyl alcohol in 2 hospitals. Patients aged 16 years or older with suspected bloodstream infection who were allocated in the emergency room, internal medicine ward, or intensive care unit were included.
Five of 563 (0.9%) blood cultures from the isopropyl arm and 10 of 539 (1.9%) from the chlorhexidine arm were contaminated. No significant differences were observed among the rate of contamination (χ=1.27; P = .3) or the relative risk of contamination (relative risk = 2.09; 95% confidence interval, 0.72-6.07; P = .2).
The rates of blood contamination were not different when isopropyl alcohol and chlorhexidine were compared. Isopropyl alcohol could be used for skin antisepsis before blood collection.
血培养假阳性会导致不必要的风险和抗生素的滥用;为降低假阳性率,确定是否需要使用具有长效作用的防腐剂将很有帮助。
在两家医院进行疗效的临床研究(双盲和随机),比较使用70%异丙醇或2%葡萄糖酸氯己定的70%异丙醇溶液进行皮肤消毒时血培养污染率。纳入年龄在16岁及以上、在急诊室、内科病房或重症监护病房被分配的疑似血流感染患者。
异丙醇组563份血培养中有5份(0.9%)被污染,氯己定组539份中有10份(1.9%)被污染。污染率(χ=1.27;P = 0.3)或污染相对风险(相对风险=2.09;95%置信区间,0.72 - 6.07;P = 0.2)之间未观察到显著差异。
比较异丙醇和氯己定后,血污染率没有差异。异丙醇可用于采血前的皮肤消毒。