Microbiology Department, Southern Community Laboratories, Dunedin and The New Zealand Microbiology Network.
The New Zealand Microbiology Network and the Microbiology Department, Pathlab, Tauranga.
N Z Med J. 2022 Jan 20;136(1568):65-71. doi: 10.26635/6965.5930.
To audit key quality indicators for blood culture (BC) practices across Aotearoa New Zealand to facilitate national BC practice peer review and promote BC quality improvement interventions.
Microbiology laboratories providing diagnostic services to district health board (DHB) hospitals were invited to participate. Practice was compared against published BC recommendations. Laboratories were required to submit data for BC positivity and contamination rates, BC bottle fill volume and the proportion of BC received as a single set.
Laboratories serving 15 of the 20 DHBs participated in the audit. Nine DHBs (60%) demonstrated a positivity rate within the target range of 8% to 15%. Eight DHBs (53%) reported a contamination rate lower than the accepted 3%, but seven (47%) DHBs exceeded this target and two reported a contamination rate greater than 5%. Mean BC bottle fill volumes were generally greater than the target of 8mL, but this volume was not reached by three DHBs and a further three were unable to provide fill volume data. No DHB met the audit standard for single-set BCs representing <20%, and for six DHBs single-set BC comprised more than half of all samples. No DHB failed all audit targets.
This audit demonstrates wide variation in BC performance across New Zealand. In most instances an inadequate volume of blood is being collected, lowering the chance of culturing a pathogen. A significant opportunity for improvement exists; clinical services and laboratories are encouraged to work together to implement targeted quality improvement processes to correct deficiencies in practice.
审核新西兰奥塔哥的血培养（BC）实践的关键质量指标，以促进全国 BC 实践同行评审，并促进 BC 质量改进干预措施。
邀请提供诊断服务给地区卫生委员会（DHB）医院的微生物学实验室参与。实践情况与已发布的 BC 建议进行了比较。实验室需提交 BC 阳性率和污染率、BC 瓶灌装量以及作为一组收到的 BC 比例的数据。
参与审计的实验室服务于 20 个 DHB 中的 15 个。九个 DHB（60%）的阳性率在 8%至 15%的目标范围内。八个 DHB（53%）报告的污染率低于可接受的 3%，但有七个 DHB（47%）超过了这一目标，两个 DHB 报告的污染率大于 5%。BC 瓶的平均灌装量通常大于 8mL 的目标，但有三个 DHB 没有达到这一标准，另有三个 DHB 无法提供灌装量数据。没有一个 DHB 达到<20%的单组 BC 审计标准，而且对于六个 DHB，单组 BC 占所有样本的一半以上。没有一个 DHB 未能达到所有审计目标。
本次审计表明，新西兰各地的 BC 性能存在广泛差异。在大多数情况下，采集的血液量不足，降低了培养病原体的机会。有很大的改进空间；鼓励临床服务和实验室共同努力，实施有针对性的质量改进流程，纠正实践中的缺陷。
