Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Strasse, Building 43, 66421, Homburg/Saar, Germany.
Department of Anaesthesiology, Intensive Care and Analgesic Therapy, Saarland University, Homburg/Saar, Germany.
Infection. 2024 Feb;52(1):183-195. doi: 10.1007/s15010-023-02083-y. Epub 2023 Aug 17.
Blood culture (BC) diagnostics are influenced by many factors. We performed a targeted interdisciplinary analysis to analyse effects of various measures on BC diagnostics performance.
A diagnostic stewardship initiative was conducted at two intervention and two control wards in a German tertiary level hospital. The initiative comprised staff training on the correct indications and sampling for BC, implementation of information cards, labels to identify the collection site, regular BC bottle feedback including the number of bottles, filling volumes and identified pathogens; and the use of a specific sampling device (BD Vacutainer). Before and after the interventions, two three-month measurement periods were performed, as well as a one-month follow-up period to assess the sustainability of the conducted measures.
In total, 9362 BC bottles from 787 patients were included in the analysis. The number of BCs obtained from peripheral venous puncture could be increased at both intervention wards (44.0 vs. 22.2%, 58.3 vs. 34.4%), while arterial sampling could be reduced (30.6 vs. 4.9%). A total of 134 staff members were fully trained. The intervention led to a considerable increase in BC knowledge (from 62.4 to 79.8% correct answers) with differences between the individual professional groups. Relevant reduced contamination rates could be detected at both intervention wards.
As knowledge on the correct BC sampling and strategies to reduce contamination varies considerably between clinical departments and healthcare professionals, a targeted training should be adapted to the specific needs of the individual professional groups. An additional filling device is not necessary.
血液培养（BC）诊断受到许多因素的影响。我们进行了一项针对性的跨学科分析，以分析各种措施对 BC 诊断性能的影响。
在德国一家三级医院的两个干预病房和两个对照病房开展了一项诊断管理计划。该计划包括对 BC 的正确适应证和采样进行员工培训、实施信息卡、用于识别采集部位的标签、定期反馈 BC 瓶，包括瓶数、灌装量和鉴定的病原体；以及使用特定的采样装置（BD Vacutainer）。在干预前后，进行了两个为期三个月的测量期，以及一个为期一个月的随访期，以评估所实施措施的可持续性。
共纳入了 787 例患者的 9362 个 BC 瓶。在两个干预病房，外周静脉穿刺采集的 BC 数量均有所增加（44.0%比 22.2%，58.3%比 34.4%），而动脉采样数量减少（30.6%比 4.9%）。共对 134 名员工进行了全面培训。干预措施使 BC 知识有了显著提高（正确答案从 62.4%提高到 79.8%），不同专业组之间存在差异。在两个干预病房均检测到相关污染率的显著降低。
由于正确的 BC 采样知识以及减少污染的策略在临床科室和医疗保健专业人员之间差异很大，因此应根据各专业组的具体需求进行有针对性的培训。不需要额外的灌装装置。
