血液培养在医疗和外科重症监护病房和病房中的使用
Valeria Fabre1, Yea-Jen Hsu2, Karen C Carroll3
1Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA network open
|January 15, 2025
概括
美国医院缺乏血液培养 (BC) 使用的基准. 这项研究描述了成人重症监护病房和病房的BC使用情况,根据病房类型和医院规模发现了显著的差异,这表明阳性率可以指导适当的使用.
科学领域:
- 临床微生物学 临床微生物学
- 改善医疗保健质量 改善医疗保健质量
- 传染病流行病学 传染病流行病学
背景情况:
- 美国医院的血液培养 (BC) 使用基准仍未确定.
- 描述当前的BC使用对于优化诊断策略和患者护理至关重要.
研究的目的:
- 在美国各医院的成人重症监护室 (ICU) 和病房中描述血培养的使用.
- 根据单位类型和医院特征建立BC利用的基准.
主要方法:
- 追溯横截面研究分析了来自美国急症医院成年ICU和病房的BC数据.
- 利用混合效应负二项式回归来确定每1000个患者日的调整平均BC使用量.
- 根据单位类型,医院床位大小,地理区域,季节性和COVID-19病例负载进行调整.
主要成果:
- 每1000个患者日的调整平均BC使用量有显著差异:医疗ICU的273.1,医疗外科ICU的146.0,医疗病房的80.3,医疗外科病房的65.1.
- 在大型医院 (>500床位) 和西中西部地区,BC使用率更高.
- 阳性BC率低于10%,污染率一般在推值内.
结论:
- 在不同的医院单位和地区,BC使用存在显著的变化.
- 血培养阳性率可以作为一个有价值的指标,指导特定单位类型的适当BC利用.
- 建立对BC使用的单位特定基准对于改善诊断管理至关重要.
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