Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
S Afr Med J. 2022 Feb 1;112(2):13503.
Bloodstream infections are an important cause of mortality in children. Blood cultures (BCs) remain the primary means of identifying organisms and their antibiotic susceptibility profiles. A shortcoming of BCs is that up to 56% of positive cultures will represent contaminants. Poor adherence to standard practices applicable to BC sampling could explain an unacceptable contamination rate.
To determine: (i) the BC contamination rate in the departments of paediatrics and child health at two tertiary hospitals in central South Africa; and (ii) BC sampling practices among paediatric clinicians.
The author determined the prevalence of BC contamination by analysis of laboratory data for the period 1 May - 27 August 2019, and assessed possible factors contributing to BC contamination by surveying paediatric medical staff with a self-administered BC practices questionnaire.
Of the 244 BCs reviewed, 25.4% were positive. The most commonly isolated pathogens were coagulase-negative staphylococci (CoNS) (33.3%), Escherichia coli (22.2%), Enterococcus faecium (16.7%) and Acinetobacter baumannii (11.1%). In total, 15.2% of the BCs yielded contaminants and 2.9% had polymicrobial growth. The most common contaminant was CoNS. Approximately 68% of clinicians were not aware of BC sampling guidelines, and even among those who were aware of the guidelines, non-compliance was reported.
The BC contamination rate was higher than internationally accepted rates. Educating clinicians on specific BC sampling guidelines is strongly recommended to decrease the high rate of contamination observed in this study.
血流感染是儿童死亡的重要原因。血培养（BC）仍然是识别病原体及其抗生素敏感性的主要手段。BC 的一个缺点是，多达 56%的阳性培养物将代表污染物。对适用于 BC 采样的标准实践的依从性差可能解释了不可接受的污染率。
确定：（i）南非中部两家三级医院儿科和儿童保健部门的 BC 污染率；和（ii）儿科临床医生的 BC 采样实践。
作者通过分析 2019 年 5 月 1 日至 8 月 27 日期间的实验室数据来确定 BC 污染的流行率，并通过对儿科医务人员进行自我管理的 BC 实践问卷调查来评估可能导致 BC 污染的因素。
在审查的 244 份 BC 中，有 25.4%呈阳性。最常见的分离病原体是凝固酶阴性葡萄球菌（CoNS）（33.3%）、大肠杆菌（22.2%）、屎肠球菌（16.7%）和鲍曼不动杆菌（11.1%）。总的来说，15.2%的 BC 产生污染物，2.9%有混合微生物生长。最常见的污染物是 CoNS。大约 68%的临床医生不知道 BC 采样指南，即使是那些知道指南的临床医生，也报告了不遵守的情况。
BC 的污染率高于国际公认的比率。强烈建议教育临床医生特定的 BC 采样指南，以降低本研究中观察到的高污染率。
