Nizam Rabia, Jalal Amna Amir, Hussain Syed Ibad
Department of Medicine, Jinnah Sindh Medical University, V22W+F2H، Rafiqui H.J, Iqbal Shaheed Rd, Karachi Cantonment Karachi, Karachi, Sindh 75510, Pakistan.
Infection. 2025 Apr 30. doi: 10.1007/s15010-025-02545-5.
The research conducted by Tolle et al. sheds light on the rising rates of blood culture contaminations (BCC) during and after the COVID-19 pandemic. However, there are several important areas that need more attention to make the study more relevant and impactful. This letter points out some key issues, such as how the training of less experienced staff might affect BCC rates, the risk of misclassification bias even with set classification criteria, the lack of patient-specific risk assessments, and the absence of procedural audits to check for failures in aseptic techniques. It's well-known that having trained personnel can help lower BCC rates, which suggests that simply having staff turnover might not explain the increase we've seen. Moreover, misclassifying contaminants as actual infections-or the other way around-can lead to serious clinical consequences, like unnecessary antibiotic prescriptions and higher healthcare costs. Additionally, certain high-risk groups, such as patients with central venous catheters or chronic conditions, might be more affected by BCC, but the study doesn't take these factors into account. Finally, without observational audits, it's hard to determine if procedural mistakes or other outside factors played a role in the rise of contamination rates. Tackling these issues is essential for improving blood culture practices, boosting diagnostic accuracy, and reducing the unintended effects of BCC in healthcare settings after the pandemic. Future research should focus on thorough assessments of staff training, risk stratification models, and real-time audits of procedures to create targeted strategies aimed at lowering contamination rates and enhancing patient outcomes.
托勒等人进行的研究揭示了新冠疫情期间及之后血培养污染（BCC）率不断上升的情况。然而，有几个重要领域需要更多关注，以使该研究更具相关性和影响力。这封信指出了一些关键问题，比如经验不足的工作人员的培训可能如何影响BCC率、即使有既定的分类标准也存在错误分类偏差的风险、缺乏针对患者的风险评估，以及没有程序审核来检查无菌技术是否存在失误。众所周知，拥有经过培训的人员有助于降低BCC率，这表明仅仅是人员更替可能无法解释我们所看到的增加情况。此外，将污染物误分类为实际感染——或者反之亦然——可能会导致严重的临床后果，比如不必要的抗生素处方和更高的医疗成本。此外，某些高危人群，如患有中心静脉导管或慢性病的患者，可能更容易受到BCC的影响，但该研究并未考虑这些因素。最后，如果没有观察性审核，就很难确定程序错误或其他外部因素是否在污染率上升中起了作用。解决这些问题对于改善血培养操作、提高诊断准确性以及减少疫情后医疗环境中BCC的意外影响至关重要。未来的研究应专注于对工作人员培训、风险分层模型以及程序的实时审核进行全面评估，以制定旨在降低污染率和改善患者预后的针对性策略。
