急诊科菌血症病例的季节性。
Seasonality of bacteremia cases in an emergency department.
机构信息
Servicio de Urgencias, Hospital Clínico Universitario Lozano Blesa, Universidad de Zaragoza. Grupo INFURG-SEMES, Zaragoza, España.
Servicio de Urgencias, Hospital Miguel Servet, Zaragoza, España.
出版信息
Emergencias. 2019;31(6):399-403.
OBJECTIVES
To assess seasonal variation in episodes of bacteremia.
MATERIAL AND METHODS
Retrospective cohort study of cases of significant bacteremia found in blood cultures ordered in a hospital emergency department. The incidence, etiology, diagnostic and prognostic yield were analyzed for each season of the year.
RESULTS
A total of 4384 blood cultures were ordered in 4.1% of the emergency patients attended. The diagnostic yield was 12.2% (incidence, 490 cases per 100 000 cases attended). Cultures were ordered more often in winter (in 4.6% of the patients vs in 3.8% in the other seasons on average, P<.001). The diagnostic yield was lower in winter than in the other seasons (10.2% vs 13%, P=.01), and the contamination rate was higher (4.9% vs 3.8%, P=.02). Escherichia coli was isolated in fewer cultures in winter than in other seasons (36.4% vs 46.9%, P=.03), and Streptococcus pneumoniae was isolated in more (14.5% vs 5.9%, P=.001).
CONCLUSION
The microbiological profile of blood cultures, their diagnostic yield, and rate of contamination differ greatly in winter.
目的
评估菌血症发作的季节性变化。
材料和方法
对医院急诊科送检的血培养中发现的大量菌血症病例进行回顾性队列研究。分析了每年各季的发病率、病因、诊断和预后。
结果
在就诊的 4.1%的急诊患者中，共送检了 4384 份血培养。诊断率为 12.2%（发病率为每 100000 例就诊患者中有 490 例）。冬季送检的培养物更多（平均占患者的 4.6%，而其他季节为 3.8%，P<.001）。冬季的诊断率低于其他季节（10.2%比 13%，P=.01），污染率更高（4.9%比 3.8%，P=.02）。冬季分离的大肠埃希菌培养物少于其他季节（36.4%比 46.9%，P=.03），而肺炎链球菌分离的培养物更多（14.5%比 5.9%，P=.001）。
结论
血培养的微生物学特征、诊断率和污染率在冬季有很大差异。
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