2016-2019年上海市101所医院发热病例血培养标本送检调查

Investigation and analysis of blood sample submission of fever patients from 101 hospitals in shanghai from 2016 to 2019

目的分析上海市101所医院2016-2019年血培养标本送检情况。方法上海市医院感染质控中心对市监测网101所医院每季度开展一次血培养标本送检率调查,对该季度最后一个月第2周的前三天发热≥38.5℃的住院患者信息及血标本送检情况进行收集和分析,数据采用SPSS 20.0软件进行录入和分析。结果2016-2019年,上海市101所医院发热患者血培养标本总送检率分别为56.71%、57.84%、58.31%、62.16%,呈逐年上升趋势(线性χ^(2)=49.360,P<0.001);ICU和普通病房发热患者前三日抗菌药物总使用率为81.70%~92.96%。发热患者伴疑似肺部感染时血培养标本送检率为67.47%~75.06%;伴留置深静脉导管>5 d时血培养标本送检率为64.72%~71.11%;送检痰标本同时送检血培养标本率为76.53%~77.15%。未送检原因合理比例呈逐年上升趋势。结论上海市101所医院血培养标本送检率呈逐年上升,但送检前抗菌药物使用率较高,高危合并因素条件下送检率有待进一步提升。

OBJECTIVE To analyze the submission of blood culture samples from 101 hospitals in shanghai from 2016 to 2019.METHODS The submission rate of quarterly survey on the blood culture samples collected from the inpatients with fever in 101 hospitals,which were under the surveillance net by Shanghai Nosocomial Infection Quality Control Center were investigated.The data of the patients with the body temperature≥38.5℃in the first three days of the second week in the last month of each quarter were collected and analyzed by using statistical software SPSS 20.0.RESULTS The inspection rates of blood culture specimens from 101 hospitals were 56.71%in 2016,57.84%in 2017,58.31%in 2018 and 62.16%in 2019,respectively,showing a upward trend year by year(linearχ^(2)=49.360,P<0.001).The total rate of antibiotics use in the first three days of hospitalization was 81.70%~92.96%in ICU and general ward.The submission rate of blood culture specimens of the fever patients complicated with suspected pulmonary infection was 67.47%~75.06%.The submission rate of blood culture samples of patients indwelling deep venous catheter>5 days was 64.72%~71.11%.The submission rate of both blood samples and sputum samples was 76.53%~77.15%.The proportion of reasonable reason of no submission was increasing year by year.CONCLUSION The submission rate of the blood samples from 101 hospitals in Shanghai was increasing between 2016 to 2019,but the application rate of antibiotics was high before submission.It is necessary to improve the blood samples submission under the condition of high-risk combined factors.