Department of Microbiology and Immunology, University of Health and Allied Sciences, Ho PMB 31, Volta Region, Ghana.
Laboratory Department, Ho Teaching Hospital, Ho P.O. Box MA 374, Volta Region, Ghana.
Int J Environ Res Public Health. 2023 Aug 23;20(17):6631. doi: 10.3390/ijerph20176631.
Blood Culture and Drug Susceptibility Testing (CDST) remains vital for the diagnosis and management of bloodstream infections (BSIs). While the Ghana National Standard Treatment Guidelines require CDST to be performed in each case of suspected or clinically diagnosed BSI, these are poorly adhered to in the Ho Teaching Hospital (HTH). This study used secondary medical and laboratory records to describe blood CDST requests by clinicians and the quality of CDST processes for the diagnosis of BSI among patients admitted to HTH from 2019 to 2021. Of 4278 patients, 33% were infants. Pneumonia and neonatal sepsis cases were 40% and 22%, respectively. Only 8% (351/4278) had blood CDST requested. Of 94% (329/351) blood CDST processed and reported, only 7% (22/329) were culture-positive, with likely contaminants being recovered from 16% (52/329) of the specimens. The duration from admission to request was 2 days (IQR: 0-5), and Further qualitative studies must be conducted to understand the reasons for low blood CDST utilisation among clinicians and the patient outcomes. Targeted interventions are required to enhance the utilisation of blood CDST by clinicians and the quality of laboratory processes.
血培养和药敏试验（CDST）对于诊断和治疗血流感染（BSI）仍然至关重要。尽管加纳国家标准治疗指南要求在疑似或临床诊断为 BSI 的每个病例中进行 CDST，但在豪教学医院（HTH）并未得到很好的遵守。本研究使用二级医疗和实验室记录，描述了 2019 年至 2021 年期间在 HTH 住院的患者中临床医生对血液 CDST 的请求以及 CDST 过程对 BSI 诊断的质量。在 4278 名患者中，33%为婴儿。肺炎和新生儿败血症的病例分别为 40%和 22%。仅有 8%（351/4278）的患者要求进行血液 CDST。在处理和报告的 94%（329/351）血液 CDST 中，仅有 7%（22/329）为培养阳性，16%（52/329）的标本中回收了可能的污染物。从入院到请求的时间为 2 天（IQR：0-5），需要进行进一步的定性研究，以了解临床医生对血液 CDST 利用率低的原因以及患者的结局。需要采取针对性的干预措施，提高临床医生对血液 CDST 的利用率和实验室流程的质量。
