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血液培养的质量指标:法国某医院使用 BacT/Alert Virtuo 监测 1 年的结果。

Quality indicators for blood culture: 1 year of monitoring with BacT/Alert Virtuo at a French hospital.

机构信息

Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.

UMR-S 1184, Paris-Saclay University, Le Kremlin-Bicêtre, France.

出版信息

J Med Microbiol. 2021 Mar;70(3). doi: 10.1099/jmm.0.001300. Epub 2020 Dec 17.

Abstract

Blood culture (BC) remains the gold standard for the diagnosis of bloodstream infection. Clinical microbiology laboratories must ensure the quality of their BC process from receipt to definitive results. In this study, we followed the evolution of different quality indicators for BCs over the first year of implementation of the BacT/Alert Virtuo system in a French hospital. In our laboratory, we instituted regular monitoring of several quality indicators to track (i) delays in sample registration, (ii) delays in loading BC bottles in our incubating system (BacT/Alert Virtuo) after registration, (iii) the volume of blood in bottles and (iv) the contamination rates. For 53 892 BC bottles loaded in the BacT/Alert Virtuo from 23 January to 31 December 2019, the delays in sample registration, loading and unloading were respectively 3.5 h±0.016, 44 min±0.209 and 5.8 h±0.0727. Intriguingly, the automated process performed by the BacT/Alert Virtuo system to check the blood volume in bottles was only performed for 60 % of the loaded bottles. Among these, 30 % contained the recommended volume of blood (between 7 and 13 ml). Finally, the contamination rate was found to be 27.2 % for samples at our institution. The delays in sample registration, loading and unloading were found to be acceptable, even though they could be improved by ensuring a continuous service during the night duty period. Furthermore, the percentage of volumes measured is insufficient and must be improved and the majority of bottles do not contain the recommended blood volume.

摘要

血培养(BC)仍然是诊断血流感染的金标准。临床微生物学实验室必须确保从收到到最终结果的 BC 过程的质量。在这项研究中,我们在法国一家医院实施 BacT/Alert Virtuo 系统的第一年中,跟踪了不同 BC 质量指标的演变。在我们的实验室中,我们定期监测了几个质量指标,以跟踪(i)样本登记的延迟,(ii)在注册后将 BC 瓶装入我们的孵育系统(BacT/Alert Virtuo)中的延迟,(iii)瓶中的血量和(iv)污染率。对于 2019 年 1 月 23 日至 12 月 31 日期间装入 BacT/Alert Virtuo 的 53892 个 BC 瓶,样本登记、加载和卸载的延迟分别为 3.5 小时±0.016、44 分钟±0.209 和 5.8 小时±0.0727。有趣的是,BacT/Alert Virtuo 系统执行的自动检查瓶中血量的过程仅对加载瓶的 60%进行。其中,30%的瓶中含有推荐的血量(7 至 13ml 之间)。最后,我们机构的样本污染率为 27.2%。样本登记、加载和卸载的延迟是可以接受的,即使通过确保夜间值班期间的连续服务,这些延迟仍可以得到改善。此外,测量的体积百分比不足,必须加以改进,并且大多数瓶子中没有包含推荐的血量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10c2/8346724/82f031a4572b/jmm-70-300-g001.jpg

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