Hills Angela Zara, Greenslade Jaimi, Ray Mercedes, Williams Julian
Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Antimicrob Steward Healthc Epidemiol. 2025 Sep 5;5(1):e200. doi: 10.1017/ash.2025.10085. eCollection 2025.
To determine the frequency and outcomes of early follow-up blood cultures (BCs) collected within 48 hours of patients being investigated for bacteremia in the emergency department (ED), as well as the number of new pathogens isolated.
Retrospective observational study of patients who had BCs collected in the ED between October 2019 and July 2020.
This study was conducted in a large, metropolitan ED with annual census of over 82,000 adult presentations. ED patients who had BCs collected during the study period were identified, and those who had BCs recollected within 48 hours were identified as having early follow-up BCs. The characteristics of these patients were compared to those without early follow-up BC collection. Logistic regression analyses were conducted to determine relationships between specific pathogens in EDBCs and early follow-up BC collection.
During the study period, 68,330 patients were treated in the ED, and BCs were collected from 1821 (2.7%). Of these, 449 (24.7%) had BCs recollected within 48 hours of their initial ED workup (early follow-up BCs) and were re-cultured 789 times across their collective stays. Five patients (1.1%) grew pathogens not isolated in EDBCs, all of which were susceptible to concurrent antimicrobials. No new pathogens were isolated in BCs taken >48 hours post ED workup.
Collection of early follow-up BCs was common. However, the rate of new pathogen growth was low and contributed minimally to patient management. Given associated costs and patient discomfort, the practice should be discouraged unless to clarify potential false positive results in ED BC.
确定在急诊科（ED）对疑似菌血症患者进行调查后48小时内采集的早期随访血培养（BC）的频率和结果，以及分离出的新病原体数量。
对2019年10月至2020年7月在急诊科采集血培养的患者进行回顾性观察研究。
本研究在一家大型都市急诊科进行，该科室每年成年患者就诊人数超过82000人。确定在研究期间采集了血培养的急诊科患者，将那些在48小时内再次采集血培养的患者确定为有早期随访血培养。将这些患者的特征与未进行早期随访血培养的患者进行比较。进行逻辑回归分析以确定急诊科血培养中的特定病原体与早期随访血培养之间的关系。
在研究期间，68330名患者在急诊科接受治疗，其中1821名（2.7%）采集了血培养。其中，449名（24.7%）在首次急诊科检查后48小时内再次采集了血培养（早期随访血培养），在他们的整个住院期间共进行了789次重新培养。5名患者（1.1%）培养出了在急诊科血培养中未分离出的病原体，所有这些病原体均对同时使用的抗菌药物敏感。在急诊科检查后>48小时采集的血培养中未分离出新的病原体。
早期随访血培养的采集很常见。然而，新病原体生长率较低，对患者管理的贡献微乎其微。考虑到相关成本和患者不适，除非是为了澄清急诊科血培养中潜在的假阳性结果，否则应不鼓励这种做法。
