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中国教学医院临床微生物学实验室的血培养质量和周转时间:一项多中心研究。

Blood culture quality and turnaround time of clinical microbiology laboratories in Chinese Teaching Hospitals: A multicenter study.

机构信息

Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.

出版信息

J Clin Lab Anal. 2024 Jan;38(1-2):e25008. doi: 10.1002/jcla.25008. Epub 2024 Jan 18.

Abstract

PURPOSE

Blood culture (BC) remains the gold standard for the diagnosis of bloodstream infections. Improving the quality of clinical BC samples, optimizing BC performance, and accelerating antimicrobial susceptibility test (AST) results are essential for the early detection of bloodstream infections and specific treatments.

METHODS

We conducted a retrospective multicenter study using 450,845 BC specimens from clinical laboratories obtained from 19 teaching hospitals between 1 January 2021 and 31 December 2021. We evaluated key performance indicators (KPIs), turnaround times (TATs), and frequency distributions of processing in BC specimens. We also evaluated the AST results of clinically significant isolates for four different laboratory workflow styles.

RESULTS

Across the 10 common bacterial isolates (n = 16,865) and yeast isolates (n = 1011), the overall median (interquartile range) TATs of AST results were 2.67 (2.05-3.31) and 3.73 (2.98-4.64) days, respectively. The specimen collections mainly occurred between 06:00 and 24:00, and specimen reception and loadings mainly between 08:00 and 24:00. Based on the laboratory workflows of the BCs, 16 of the 19 hospitals were divided into four groups. Time to results (TTRs) from specimen collection to the AST reports were 2.35 (1.95-3.06), 2.61 (1.98-3.32), 2.99 (2.60-3.87), and 3.25 (2.80-3.98) days for groups I, II, III, and IV, respectively.

CONCLUSION

This study shows the related BC KPIs and workflows in different Chinese hospitals, suggesting that laboratory workflow optimization can play important roles in shortening time to AST reports and initiation of appropriate timely treatment.

摘要

目的

血培养(BC)仍然是诊断血流感染的金标准。提高临床 BC 样本的质量,优化 BC 性能,加快抗菌药物敏感性试验(AST)结果,对于早期发现血流感染和进行针对性治疗至关重要。

方法

我们进行了一项回顾性多中心研究,使用了 2021 年 1 月 1 日至 2021 年 12 月 31 日期间,19 所教学医院的临床实验室获得的 450,845 份 BC 标本。我们评估了关键绩效指标(KPI)、周转时间(TAT)和 BC 标本处理的频率分布。我们还评估了四种不同实验室工作流程模式下临床有意义分离株的 AST 结果。

结果

在 10 种常见细菌分离株(n=16865)和酵母分离株(n=1011)中,AST 结果的总中位数(四分位距)TAT 分别为 2.67(2.05-3.31)和 3.73(2.98-4.64)天。标本采集主要发生在 06:00 至 24:00 之间,标本接收和加载主要发生在 08:00 至 24:00 之间。根据 BC 的实验室工作流程,19 家医院中的 16 家被分为四组。从标本采集到 AST 报告的 TTR 分别为 2.35(1.95-3.06)、2.61(1.98-3.32)、2.99(2.60-3.87)和 3.25(2.80-3.98)天,分别为组 I、II、III 和 IV。

结论

本研究展示了不同中国医院相关的 BC KPI 和工作流程,提示实验室工作流程优化在缩短 AST 报告时间和及时启动适当治疗方面发挥着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9322/10829685/42d2fa92c90e/JCLA-38-e25008-g002.jpg

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