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管理包对血培养采集的影响。

Effect of the introduction of a management bundle for blood culture collection.

机构信息

Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan; Department of Central Clinical Laboratory, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan.

Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan; Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan.

出版信息

Am J Infect Control. 2022 Jul;50(7):772-776. doi: 10.1016/j.ajic.2021.11.019. Epub 2021 Dec 2.

Abstract

BACKGROUND

Inappropriate blood collection subjected to blood culture (BC) causes BC contamination and may complicate the diagnose is of infectious diseases. Therefore, we developed a bundle based on the guideline recommendations for appropriate blood collection and examined the effects of bundle introduction.

METHODS

We performed a retrospective analysis of BC samples to determine the contamination rates before and after introducing the BC bundle. We also analyzed the correlation between the compliance rate of the bundle and contamination rate, and between each bundle element and contamination.

RESULTS

After the introduction of the bundle, the contamination rate was significantly reduced from 5.4% ± 0.9% to 1.7± 0.7% (P < .01). The compliance rate of the bundle was significantly associated with a lower contamination rate (P < .01). Multivariable logistic regression showed that collection from superficial veins of the cubital fossa (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.13-0.51, P < .01) and disinfection of the skin at the blood collection site with 1% chlorhexidine alcohol swab (OR, 0.41; 95% CI, 0.25-0.68, P < .01) were significantly associated with lower contamination.

CONCLUSIONS

This study suggests that the introduction of the BC bundle significantly reduced the contamination rate, and bundle compliance was associated with a lower contamination rate.

摘要

背景

不适当的血液采集进行血培养(BC)会导致 BC 污染,并可能使传染病的诊断复杂化。因此,我们根据适当的血液采集指南建议制定了一个捆绑包,并检查了引入捆绑包的效果。

方法

我们对 BC 样本进行了回顾性分析,以确定引入 BC 捆绑包前后的污染率。我们还分析了捆绑包的依从率与污染率之间的相关性,以及每个捆绑包元素与污染之间的相关性。

结果

引入捆绑包后,污染率从 5.4%±0.9%显著降低至 1.7±0.7%(P<.01)。捆绑包的依从率与较低的污染率显著相关(P<.01)。多变量逻辑回归显示,从肘窝的浅静脉采集(比值比[OR],0.25;95%置信区间[CI],0.13-0.51,P<.01)和使用 1%洗必泰酒精棉签对采血部位进行皮肤消毒(OR,0.41;95%CI,0.25-0.68,P<.01)与较低的污染显著相关。

结论

本研究表明,引入 BC 捆绑包显著降低了污染率,并且捆绑包的依从率与较低的污染率相关。

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