Division of Pediatric Infectious Diseases,Johns Hopkins School of Medicine,Baltimore, Maryland.
Division of Critical Care,Children's Hospital of Philadelphia,Philadelphia, Pennsylvania.
Infect Control Hosp Epidemiol. 2019 Apr;40(4):482-484. doi: 10.1017/ice.2019.10. Epub 2019 Feb 15.
Blood cultures are essential for the evaluation of sepsis. However, they may sometimes be obtained inappropriately, leading to high false-positive rates, largely due to contamination.1 As a quality improvement project, clinician decision-support tools for evaluating patients with fever or signs and symptoms of sepsis were implemented in April 2014 in our pediatric intensive care unit (PICU). This initiative resulted in a 46% decrease in blood culture obtainment2 and has been replicated in other institutions.3 It is important to evaluate antibiotic use as a balancing measure because a reduction in blood cultures could lead to an increase in antibiotic treatment days if clinicians continued empiric treatment in scenarios when blood culture results were not available. The objective of this study was to evaluate whether antibiotic use in the PICU changed in association with a reduction in blood culture utilization.
血培养对于脓毒症的评估至关重要。然而，有时可能会不恰当地获取血培养，导致高假阳性率，这主要是由于污染所致。1 作为一项质量改进项目，我们于 2014 年 4 月在儿科重症监护病房（PICU）实施了用于评估发热或脓毒症体征和症状患者的临床医生决策支持工具。这一举措使血培养的获取量减少了 46%2，并在其他机构得到了复制。3 评估抗生素的使用情况是很重要的，因为如果临床医生在没有血培养结果的情况下继续经验性治疗，那么血培养的减少可能会导致抗生素治疗天数的增加。本研究的目的是评估与血培养利用减少相关的 PICU 中抗生素使用是否发生了变化。
