儿童血流感染血培养采集的最佳证据总结

Best-practice evidence on blood culture collection for children with bloodstream infection

目的:检索、评价和整合儿童血流感染患儿血培养采集的最佳实践证据。方法:按照6S模型,检索BMJ best practice,UpToDate.英国国家卫生与临床优化研究所指南网(NICE Guidance).苏格兰院际指南网(SIGN)、安大略注册护士协会(RNAO)、国际指南协作网(GIN)、美国国立指南库(NGC)、医脉通、美国临床和实验室标准协会(CLSI)、世界卫生组织官网(WHO)、PubMed、CINAHL.Cochrane Library英文数据库、中国期刊全文数据库(CNKI)、万方数据库(Wanfang Data)、Sinomed中关于血培养标本采集管理的相关指南、标准、临床决策,补充检索最新指南发表时间之后发表的系统评价。由2名研究者对纳入的文献进行质量评价,对符合质量标准的文献进行证据提取和汇总。结果:共纳入文献7篇,包括临床决策1篇、指南4篇、系统评价2篇,最终从采血时机、采集前消毒、采集工具、采血途径、采血量、管理策略6个方面总结证据22条。结论:所总结的关于儿童血培养采集的证据可用于临床实践,促进儿童血培养采集的规范化管理,提升检出率。

Objective: To search, evaluate and integrate best practice evidence of blood culture collection in children with blood stream infection. Methods: According to the 6 s model, Guidelines were searched in following databases: Up To Date, NICE Guidance, the Scottish court guidelines network(SIGN), World Health Organization(WHO), registered nurses association of Ontario(RNAO), international guidelines for the network(GIN), the national guide Library(NGC), medlive, the clinical and laboratory standards institute(CLSI), Pubmed, CINAHL, the Cochrane Library, CNKI, Wanfang Data, Sinomed. The latest systematic reviews were supplemented. Two researchers evaluated the quality of the included literature, extracted and summarized the evidence from the literatures. Results: A total of 7 articles were included, including 1 clinical decision, 4 guidelines, 2 systematic reviews. Totally 22 pieces of evidence on 6 aspects including blood collection time, disinfection, collection tools, blood collection method, blood collection volume, management strategy were finally summarized. Conclusion: The summarized evidence of blood culture collection of children can be used in clinical practice to promote the standardized management of blood culture collection of children and improve the detection rate.