追溯队列研究,比较注射药物的人群中的两组与三组血液培养组
Michael C Shih1, Aprilgate L Wang1, Stella Radosta1
1Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
Infectious diseases (London, England)
|November 22, 2023
概括
对于注射毒品的人来说,第三组血培养组提供了有限的诊断益处,并增加了污染风险. 只在特定的临床情况下考虑第三次血培养,例如怀疑内心炎或骨质炎.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 公共卫生 公共卫生
背景情况:
- 标准的血液培养实践缺乏明确的指导,特别是对于高风险人群.
- 注射药物使用者 (PWID) 面临高血流感染 (细菌病) 和严重败血症的风险.
- 对PWID进行第三种血培养的必要性需要进一步调查.
研究的目的:
- 为了评估抽取两组血培和三组血培的临床实用性.
- 评估与PWID.中额外的血液培养相关的风险和益处.
- 为了确定第三种血液培养集的诊断产量和污染率.
主要方法:
- 追溯队列研究分析了2017-2022年的数据.
- 涉及的成年人注射毒品在一个多中心医院系统.
- 检查了来自998个人的2278个血液培养组.
主要成果:
- 第三组血液培养组在4.5%的发作中显示出潜在的益处,但病原体识别仅在2.0%中得到确认.
- 诊断所需的数字是51,而识别污染物的数字是36.
- 使用三组显著增加了污染率 (9.8%vs7.0%) 和相关并发症,包括长时间住院和不必要的抗生素.
结论:
- 针对PWID的第三种血培养的好处并不总是超过污染风险的增加.
- 第三种血液培养应保留给特定的临床适应症,如怀疑内心炎或骨髓炎.
- 优化血培养策略对于准确的诊断和适当的患者管理在这个人群中至关重要.
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