皮肤插入部位培养预测原发性血流感染。
Skin insertion site culture for the prediction of primary bloodstream infection.
机构信息
Intensive Care Unit, Hospital Universitario de Canarias, La Laguna 38320, OfraTenerife, s/n, Spain.
Microbiology and Infection Control Service, Hospital Universitario de Canarias, La Laguna 38320, OfraTenerife, s/n, Spain.
出版信息
Ir J Med Sci. 2022 Jun;191(3):1269-1275. doi: 10.1007/s11845-021-02685-1. Epub 2021 Jun 14.
PURPOSE
Previous studies have analyzed the capability of skin insertion site culture to predict catheter-related bloodstream infection (CRBSI). However, there has been not analyzed its capability to predict primary bloodstream infection (PBSI), that include CRBSI and bloodstream infection of unknown origin (BSIUO). The novel objective of our study was to determine the capability of insertion skin site culture to predict CRBSI and primary bloodstream infection (PBSI), that include CRBSI and bloodstream infection of unknown origin (BSIUO).
MATERIAL AND METHODS
Observational and prospective study in one Intensive Care Unit. Patients with some central venous catheter (CVC) at least during 7 days and suspected catheter-related infection (CRI) (new episode of fever or sepsis) were included. Cultures of insertion skin site, paired blood samples, catheter-tip, and other clinical samples were taken. Capability of insertion skin site culture to predict CRBSI and PBSI was determined.
RESULTS
We included 108 CVC from 96 CRI suspicion episodes. The causes that motivated CRI suspicion were 20 (18.5%) PBSI, 44 (40.7%) other infections, and 44 (40.7%) unknown. Among the 20 PBSI, 11 (55%) were CRBSI and 9 (45%) were BSIUO. Negative predictive value of insertion skin site culture to predict CRBSI was 95% (87-98%) and to predict PBSI was 85% (76-91%).
CONCLUSIONS
The new finding of our study was that skin insertion site culture had a good negative predicted valued for the prediction of CRBSI and PBSI.
目的
先前的研究分析了皮肤插入部位培养物预测导管相关血流感染（CRBSI）的能力。然而，尚未分析其预测原发性血流感染（PBSI）的能力，包括 CRBSI 和来源不明的血流感染（BSIUO）。我们研究的新目标是确定插入皮肤部位培养物预测 CRBSI 和原发性血流感染（PBSI）的能力，包括 CRBSI 和来源不明的血流感染（BSIUO）。
材料和方法
在一个重症监护病房进行观察性和前瞻性研究。纳入至少有 7 天中央静脉导管（CVC）并疑似发生导管相关感染（CRI）（新发热或败血症发作）的患者。采集插入皮肤部位、配对血样、导管尖端和其他临床样本进行培养。确定插入皮肤部位培养物预测 CRBSI 和 PBSI 的能力。
结果
我们纳入了 96 例 CRI 疑似发作中的 108 个 CVC。导致 CRI 疑似的原因是 20 例（18.5%）PBSI、44 例（40.7%）其他感染和 44 例（40.7%）原因不明。在 20 例 PBSI 中，11 例（55%）为 CRBSI，9 例（45%）为 BSIUO。插入皮肤部位培养物预测 CRBSI 的阴性预测值为 95%（87-98%），预测 PBSI 的阴性预测值为 85%（76-91%）。
结论
我们研究的新发现是，皮肤插入部位培养物对 CRBSI 和 PBSI 的预测具有良好的阴性预测值。
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