在固体器官移植接受者中评估血培的适当性:一种诊断管理方法
Julie M Steinbrink1, Nitin Mehdiratta2, Heather Pena3
1Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
Infection control and hospital epidemiology
|September 29, 2025
概括
一个血液培养算法,在固体器官移植 (SOT) 接受者身上进行了追溯测试,没有错过任何真正的阳性血流感染. 这支持在SOT群体中谨慎使用诊断算法.
科学领域:
- 移植医学 移植医学 移植医学
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
背景情况:
- 血液培养的诊断管理对于患者安全和资源优化至关重要.
- 关于血液培养算法的有效性在固体器官移植 (SOT) 接受者中存在有限的数据,这是一个脆弱的免疫受损人群.
- 现有的血液培养算法,主要是为非免疫受损个体开发的,需要在SOT环境中进行评估.
研究的目的:
- 追溯评估成年SOT受体中已建立的血液培养算法的性能.
- 为了确定算法是否可以准确地识别或排除这种特定患者群体中真正的阳性血流感染.
主要方法:
- 从2022年2月到2024年1月,对成人SOT接受者的血液培养事件 (BCE) 的回顾性图表审查.
- 根据机构算法对欧洲央行进行适当,不适当或缺乏文件的分类.
- 分析不合适的ECB,重点关注订单原因和文化结果.
主要成果:
- 在公元前737年中,有25%被认为不合适.
- 大多数不合适的BCE (96%) 导致负面培养或污染物,没有真正的积极结果.
- 隔离性发烧和白细胞瘤是不适当的血液培养 (74%) 的最常见触发因素.
结论:
- 血液培养算法的追溯应用并没有导致成人SOT接受者错过的真正血流感染.
- 这些发现表明,在SOT群体中,这种诊断算法可能会安全,谨慎地实施.
- 建议进行进一步的前性研究,以验证这些有希望的结果.
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