24 h卫星血培养可改进急诊病原微生物培养流程

Application evaluation of 24 h satellite blood culture to improve pathogenic microorganism culture process in emergency

目的 分析24 h卫星血培养对急诊微生物实验室血培养工作流程的影响。方法 收集2020年6月1日—2021年5月31日(第1阶段)和2021年6月1日-2022年5月31日(第2阶段)复旦大学附属中山医院设置卫星血培养前(18 208套)、后(2 810套)相关实验室数据,比较设置卫星血培养前后转运时间(TTI)、报阳时间(TTP)、革兰染色时间(TTG)、最终报告时间[样本周转时间(TAT)]的差异。结果 设置卫星血培养前、后阳性率分别为6.29%(1 146/18 208套)和9.57%(269/2 810套),差异有统计学意义(P<0.001)。在全时段、工作时段和非工作时段,设置卫星血培养后TTI、TTP和TAT均短于设置前(P<0.05),尤其是非工作时段,分别缩短3.78、7.76和16.18 h。设置卫星血培养后,肠杆菌目细菌和葡萄球菌的TTP分别较设置前缩短1.93(P=0.014)和6.59 h(P<0.001),肠杆菌目细菌和肠球菌的TAT分别缩短8.13和6.53 h(P<0.05)。结论 设置卫星血培养可显著提高血培养阳性率,缩短TTI、TTP,进而缩短TAT,实现血培养的流程优化。

Objective To analyze the influence of 24 h satellite blood culture on the blood culture workflow of emergency microbiology laboratory.Methods The relevant laboratory data were collected from June 1,2020 to May 31,2021(the 1st stage)and June 1,2021 to May 31,2022(the 2nd stage)before and after the establishment of satellite blood culture in Zhongshan Hospital of Fudan University(18208 and 2810 sets).The differences of time-to-incubation(TTI),time-to-positivity(TTP),time-to-gram stain(TTG)and final report time[turn-around time(TAT)]were compared before and after satellite blood culture.Results The positive rates before and after satellite blood culture were 6.29%(1146/18208)and 9.57%(269/2810)(P<0.001).In the whole time,working time and non-working time,TTI,TTP and TAT after satellite blood culture were shorter than those before satellite blood culture(P<0.05).In particular,the non-working times were shortened by 3.78,7.76 and 16.18 h,respectively.After satellite blood culture,the TTP of Enterobacteriaceae and Staphylococcus were decreased by 1.93 h(P=0.014)and 6.59 h(P<0.001)compared with that before satellite blood culture,and the TAT of Enterobacteriaceae and Enterococcus were decreased by 8.13 h(P<0.05)and 6.53 h(P<0.05),respectively.Conclusions Setting satellite blood culture can improve the positive rate of blood culture,shorten TTI,TTP and TAT,and realize the optimization of blood culture process.