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足够还是不足?一家三级儿童医院送检血培养的血量情况

Adequate or Inadequate? The Volume of Blood Submitted for Blood Culture at a Tertiary Children's Hospital.

作者信息

Harewood Freya C, Curtis Nigel, Daley Andrew J, Bryant Penelope A, Gwee Amanda, Connell Thomas G

机构信息

1 The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.

2 Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

出版信息

Clin Pediatr (Phila). 2018 Oct;57(11):1310-1317. doi: 10.1177/0009922818778042. Epub 2018 May 29.

Abstract

The volume of blood sampled for culture critically influences the results. This study aimed to determine (1) the volume of blood submitted for culture, (2) the proportion of blood cultures with adequate volume, (3) whether measured improvement from a previous educational intervention had been sustained, and (4) the impact of blood volume on culture result. The volume of blood submitted for cultures was determined over a 13-month period by weighing bottles before and after collection and before and after an educational intervention. The volume of blood submitted in 5127 culture bottles were measured. Fewer than 50% of all cultures were deemed adequate. A significant pathogen was isolated in 4.7% of blood cultures, and low-volume cultures were more likely to yield contaminant isolates (47/2422 [1.9%] vs 22/2705 [0.8%], P = .0005). Subsequently, the higher rate of contaminant isolates from low-volume cultures may affect selection and rationalization of antibiotic therapy.

摘要

用于培养的采血量对结果有至关重要的影响。本研究旨在确定:(1)送检培养的血量;(2)血量充足的血培养比例;(3)之前教育干预所带来的测量改善是否得以持续;(4)血量对培养结果的影响。通过在采血前后以及教育干预前后对瓶子称重,在13个月的时间里确定了送检培养的血量。对5127个培养瓶中的采血量进行了测量。所有培养中不足50%被认为血量充足。在4.7%的血培养中分离出了重要病原体,低血量培养更有可能产生污染性分离株(47/2422 [1.9%] 对比22/2705 [0.8%],P = .0005)。随后,低血量培养中污染性分离株的较高比例可能会影响抗生素治疗的选择和合理性。

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