儿童持续性血流感染:检查重复血液培养的作用
Christine M Puthawala1, Richard S Feinn2, José Rivera-Viñas3
1Department of Pediatrics, Section Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA.
Journal of clinical microbiology
|October 4, 2024
概括
在儿童中重复血培养通常是不必要的. 儿科患者的持续性血流感染 (BSI) 与金黄色葡萄球菌和酵母菌有关,而不是链球菌或无气菌. 中线增加了风险.
科学领域:
- 儿童传染病 儿童传染病
- 临床微生物学 临床微生物学
- 诊断管理管理的诊断管理.
背景情况:
- 重复血培养在儿童中很常见,最初的结果是积极的.
- 仅有有限的数据可指导儿童细菌病的重复血培养的必要性.
- 这项研究涉及儿童血液培养的诊断管理.
研究的目的:
- 确定与儿童持续性血液感染 (BSI) 相关的因素.
- 告知临床决策对重复血液培养的信息.
- 支持血液培养管理,特别是在供应短缺期间.
主要方法:
- 对儿童 (<18岁) 的横截面研究,在5年内检测出阳性血培养.
- 一般化的线性方程模型用于预测与持久的BSI相关的因素.
- 持久性BSI定义为同一生物体的阳性血液培养,指数培养后>48小时.
主要成果:
- 在502种培养中,有67种 (13.2%) 持续呈阳性.
- 金色葡萄球菌 (OR 9.45) 和酵母菌 (OR 78.18) 与持久性BSI有关.
- 之前的阳性培养 (OR 1.44) 和中央静脉导管 (OR 2.20) 增加了持续性风险. 厌氧菌和链球菌物种从来没有持续存在.
结论:
- 酵母菌和金黄色葡萄球菌是儿童持续性BSI的关键指标.
- 重复血液培养可能对所有儿科感染都没有临床价值.
- 患者因素,如先前的阳性培养或中心线预测持久性,指导有针对性的测试.
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