Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Clin Microbiol Infect. 2019 Apr;25(4):469-473. doi: 10.1016/j.cmi.2018.06.024. Epub 2018 Jun 28.
The question of whether to obtain two or three sets of blood cultures to assess the aetiology of bloodstream infections (BSIs) remains open to debate. Few studies have assessed the proportion of BSIs missed without the third blood culture set (BCS). The aim of our study was to determine the proportion of BSIs that would be missed without the third BCS in a hospital where obtaining three BCSs is the standard of care.
We performed a descriptive retrospective study in Hospital Gregorio Marañón (Madrid) from 2010 to 2013. We included all episodes of BSI in which three BCSs were systematically obtained.
We included 4000 episodes of BSI between 2010 and 2013. Without the third BCS, we would have missed 298 (7.5%) episodes of BSI: 141 (47.3%) by gram-positive microorganisms, 147 (49.3%) by gram-negative microorganisms, and 10 (3.4%) by yeasts. In 132/298 (44.3%) of the episodes another clinical sample was obtained within a week of the BCS extraction; in 101/298 (33.9%), the same microorganism was present in a significant clinical sample other than blood.
Our data suggest that performing a third BCS is useful, as not doing this could result in an unacceptable number of BSIs going undetected.
关于是否需要采集两套或三套血培养来评估血流感染（BSI）的病因仍存在争议。很少有研究评估不采集第三套血培养时会漏检多少 BSI。我们的研究旨在确定在需要采集三套血培养作为常规治疗的医院中，不采集第三套血培养时会漏检多少 BSI。
我们在 2010 年至 2013 年期间在 Gregorio Marañón 医院（马德里）进行了一项描述性回顾性研究。我们纳入了所有采集了三套血培养的 BSI 病例。
我们纳入了 2010 年至 2013 年间 4000 例 BSI 病例。如果不采集第三套血培养，我们将漏检 298 例（7.5%）BSI：141 例（47.3%）由革兰阳性菌引起，147 例（49.3%）由革兰阴性菌引起，10 例（3.4%）由酵母菌引起。在 298 例漏检的 BSI 中，有 132 例（44.3%）在采集血培养后一周内采集了另一份临床样本；在 101 例（33.9%）漏检的 BSI 中，同一微生物在血液以外的重要临床样本中存在。
我们的数据表明，进行第三套血培养是有用的，因为不这样做可能会导致无法接受数量的 BSI 漏检。
