儿童的一种血培与两种血培的收益率:检测不足和过度检测
Anat Zalmanovich1,2, Elizabeth Temkin1, Dikla Biran1
1National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv 64239, Israel.
Antibiotics (Basel, Switzerland)
|February 23, 2024
概括
获得两种血液培养 (BCs) 显著改善了儿童血液感染 (BSIs) 的检测. 第二个BC在16%的阳性病例中检测到病原体,这表明单个BC错过了许多感染.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 儿科医疗保健 儿科医疗保健
背景情况:
- 血流感染 (BSI) 是儿童群体的一个关键问题.
- 目前的诊断实践往往依赖于单个血液培养 (BCs).
- 单个BCs在儿童中检测BSI的灵敏度和特异性需要进一步研究.
研究的目的:
- 评估收集两个BCs与一个BCs对儿科患者BSI检测率的影响.
- 为了确定第二个BC在识别真正的病原体中的额外诊断产量.
- 评估污染率并将其与儿童血液培养中的真实BSI区分开来.
主要方法:
- 一项描述性研究利用了2019年至2021年间以色列儿科医院的监视数据.
- 分析了178,702次血液培养事件,比较单个和配对BC收集的结果.
- 在单一和双BC策略之间,病原体检测率和污染物识别的统计比较.
主要成果:
- 两个BC在8.9%的发作中检测到真正的病原体,而只有一个BC在1.0% (p < 0.001).
- 仅第二个BC就在16.0%的阳性配对培养物中发现了真正的病原体.
- 据估计,每年可以通过通用双BC协议检测到343个额外的BSI.
- 单个BCs具有高比例的共生细菌 (64.7%),由于潜在的污染,使BSI诊断复杂化.
结论:
- 采集两种血培养显著提高了儿童血液感染的检测.
- 单一的血液培养策略与较低的灵敏度和较高比例的模两可的结果,由于共生生物.
- 建议实施常规的两BC采集,以改善儿科BSI诊断和患者管理.
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