血培养阳性标本的目标性监测与假阳性的控制  

Target surveillance of blood culture positive samples and control of false positive

作　　者：覃凌[1] 王慕云[1] 

机构地区：[1]柳州市人民医院感染管理科,广西柳州545006

出　　处：《中华医院感染学杂志》2012年第19期4374-4375,4406,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析医院血培养假阳性的原因,探讨采取相关措施后对其发生率的影响,为指导临床诊断及合理应用抗菌药物提供客观依据。方法对2008年1-6月所有血培养阳性的病例进行目标追踪监测,了解假阳性率,分析产生的原因;2008年7月针对问题采取相应的干预措施,持续追踪2008年7月-2010年12月血培养阳性病例。结果 2008年1-6月血培养假阳性病例的病原菌分布以条件致病菌为主,其中凝固酶阴性葡萄球菌占83.33%,血培养假阳性率高达35.29%,采取控制措施后2010年7-12月血培养假阳性率下降至8.70%(χ2=9.172,P=0.002)。结论在血培养阳性目标性监测中运用持续质量改进管理模式,采取正确的干预措施,如制定标准化的血培养采集流程、多种方式加强护士相关知识及操作技能培训、加强质量督查和考核等,可提高血培养标本的送检质量,降低假阳性率,保证检验结果的正确性。OBJECTIVE To provide objective guidelines for the clinical diagnosis and rational application of antibiotics by analyzing the reasons of the false positive of blood culture and exploring the effect on its incidence after taking corresponding countermeasures.METHODS We monitored all the positive blood culture cases to find the causes of the false positive cases from Jan to Jun 2008.and the interventions were adopted in response to the problems since Jul 2008,the follow-up of the blood culture positive cases was performed during the period of Jul 2008-Dec 2010.RESULTS The conditional pathogens were dominated in the blood cultured positive cases during Jan-Jun 2008,among which coagulase-negative Staphylococcus accounted for 83.33%,the rate of false positive blood culture was 35.29%,while descending to 8.70% from Jul to Dec 2010 after taking the control measures（χ2=9.172,P=0.002）.CONCLUSION By applying quality control administration mode in target surveillance of blood culture positive,taking correct intervention measures such as instituting standardized blood culture sampling procedure and emphasizing the relevant knowledge and operation skills of the nurses as well as the intensifying the quality supervision and assessment,we can improve the quality of submission of the blood culture specimens,reduce the rate of false positive and ensure the accuracy of the examination results.

关 键 词：血培养 目标性监测 凝固酶阴性葡萄球菌 干预 

分 类 号：R378[医药卫生—病原生物学]