动脉导管血标本与静脉血标本用于血培养检测可靠性比较的Meta分析

Comparison of the reliability of arterial blood samples and venous blood samples for blood culture detection:a Meta-analysis

目的系统评价并比较动脉导管血培养标本与静脉血培养标本检测血流感染的可靠性。方法计算机检索Medline、Embase、Cochrane Library、中国知网、万方数据库、中国国家图书馆、PubMed、Science Direct、Google Scholar和ProQuest等数据库,收集动脉血培养标本与静脉血培养标本配对检测血流感染的相关研究,筛选文献、提取数据并评价文献质量后,采用RevMan5.3软件进行Meta分析。结果共纳入6条文献,Meta分析结果显示,动脉血培养标本与静脉血培养标本在确诊菌血症患者中培养物阳性检出率和标本污染率比较,差异均无统计学意义(P>0.05)。结论留取动脉血培养标本进行患者血流感染检测效果与静脉血培养标本同样可靠,甚至发现,对于某些菌种动脉血培养阳性检出效率更高,但污染风险较大。考虑到留取标本的便利性和无创性,有持续留置动脉导管的重症患者可考虑采集动脉血培养标本进行检测。

Objective To systematically review and compare the reliability of arterial blood and venous blood culture samples for diagnosis of bloodstream infection.Methods Medline,Embase,Cochrane Library,CNKI,Wanfang database,National Library of China,PubMed,Science Direct,Google Scholar,ProQuest and other databases were searched to collect the related researches on the matching detection of bloodstream infection between arterial blood culture and venous blood culture samples.Meta-analysis was conducted by RevMan 5.3 software after literature screening,data extraction and quality evaluation.Results A total of 6 studies were included.The results of Meta-analysis showed that there was no significant difference between arterial blood culture and venous blood culture in the positive detection rate of culture and contamination rate of samples in confirmed patients with bacteremia(P>0.05).Conclusion Arterial blood culture samples for detecting of bloodstream infection is as reliable as venous blood culture.It is even found that the positive detection rate of arterial blood culture is higher for some special strains but the risk of pollution is relatively high.Considering the convenience and non-invasive of sample retention,it is suggested to collect arterial blood culture samples for detection in critical ill patients with arterial catheters.