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血培养在 COVID-19 肺炎中的作用。

Usefulness of blood cultures in COVID-19 pneumonia.

机构信息

Hospital General de Agudos Dr. Carlos G. Durand, Buenos Aires, Argentina. E-mail:

Hospital General de Agudos Dr. Carlos G. Durand, Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2020;80 Suppl 6:44-47.

PMID:33481732
Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic has strained the world's health systems, highlighting the need to optimize its clinical management and treatment. The usefulness of blood cultures in patients with COVID-19 pneumonia has not been proved. We aim to describe the diagnostic yield of early blood cultures in patients with COVID-19 pneumonia in a public hospital in Buenos Aires City. This descriptive observational study included all adult patients with COVID-19 pneumonia admitted to the Internal Medicine ward of Hospital Durand between April 1, 2020 and July 30, 2020, who had blood cultures drawn within 5 days from hospital admission. Among 267 patients hospitalized with COVID-19 pneumonia, 38 had early blood cultures drawn. No clinically relevant microorganism was isolated from blood and contaminant microorganisms were recovered in 7 (18.4%) patients. This study found no evidence of bacteremia in patients with COVID-19 pneumonia. Furthermore, the rate of contaminated blood cultures nearly doubles the reported in patients with community acquired pneumonia (10%), which may be explained by unfamiliarity of additional personal protective equipment worn by healthcare workers. Our results advocate against the routine indication of blood cultures upon admission to the Internal Medicine Ward of patients with COVID-19 pneumonia. We suggest that blood cultures could only be useful in case of clinical deterioration or suspected hospital-acquired infection.

摘要

2019 年冠状病毒病(COVID-19)大流行使世界卫生系统不堪重负,凸显了优化其临床管理和治疗的必要性。COVID-19 肺炎患者的血培养的实用性尚未得到证实。我们旨在描述布宜诺斯艾利斯市一家公立医院 COVID-19 肺炎患者早期血培养的诊断效果。这项描述性观察研究纳入了 2020 年 4 月 1 日至 2020 年 7 月 30 日期间入住 Durand 医院内科病房的所有 COVID-19 肺炎成年患者,他们在入院后 5 天内进行了血培养。在 267 名因 COVID-19 肺炎住院的患者中,有 38 名患者进行了早期血培养。从血液中未分离出有临床意义的微生物,在 7 名(18.4%)患者中分离出污染微生物。本研究未发现 COVID-19 肺炎患者存在菌血症的证据。此外,污染血培养的发生率几乎是社区获得性肺炎(10%)报告的两倍,这可能是由于医护人员佩戴了不熟悉的额外个人防护设备所致。我们的研究结果不支持对 COVID-19 肺炎患者入院时常规进行血培养。我们建议仅在临床恶化或疑似医院获得性感染的情况下,血培养才可能有用。

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