血培养污染和随后的不必要的医疗保健利用在儿科
Kelsey Childress1,2, Michael Hartmann3, Marilyn L Kwan3
1Division of Hospital Pediatrics, Kaiser Permanente Northern California, Roseville, California.
Hospital pediatrics
|March 12, 2026
概括
儿童血液培养物污染导致急诊次数增加,住院时间增加,住院时间延长,耗资数百万美元. 这凸显了儿童假阳性结果对患者的重大经济负担和影响.
科学领域:
- 临床微生物学 临床微生物学
- 卫生经济学 卫生经济学
- 儿童传染病 儿童传染病
背景情况:
- 在美国,受污染的血液培养造成了大量的医疗保健费用,主要是由于使用量增加和抗生素暴露.
- 儿童群体中受污染的血液培养的经济和临床负担仍未得到充分描述.
研究的目的:
- 量化儿童患者受污染血液培养的医疗利用率和相关成本.
- 为了比较患有受污染血液培养的儿科患者和具有真正阳性或阴性结果的儿科患者之间的结果.
主要方法:
- 一项回顾性队列研究分析了从2010年至2022年期间在多中心门诊和医院环境中128,524种血液培养物.
- 具有共生生物的培养被归类为受污染的,不包括高危儿科患者.
- 在受污染和未受污染的培养群体之间,医疗保健的利用,成本,抗生素的使用和抽血频率进行了比较.
主要成果:
- 污染的血液培养显著增加了急诊室访问的几率 (15倍) 和入院的几率 (6倍).
- 患有污染培养的患者经历了32%的更长的停留时间,每位门诊污染物约为980美元,每位住院污染物约为2500美元的相关费用.
- 与非受污染的文化相比,受污染的文化导致了抗生素的增加和更频繁的血液抽取.
结论:
- 儿童血液培养物污染导致医疗保健的大量过度利用和巨大的经济成本.
- 这些发现强调,需要制定战略,尽量减少儿科护理中的血液培养污染,以降低成本和改善患者管理.
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