2016—2020年血培养污染率质量指标室间质量评价结果分析

Analysis on external quality assessment for quality indicators of blood culture contamination rate from 2016 to 2020

目的回顾分析2016—2020年血培养污染率质量指标室间质评结果,了解国内微生物实验室血培养情况,为实验室建立初步质量规范提供参考。方法国家卫生健康委临床检验中心联合31个省(自治区、直辖市)和新疆生产建设兵团临床检验中心同步开展质量指标室间质量评价计划,并通过已开发的Clinet-EQA系统在线回报结果,收集2016—2020年实验室的基本信息和血培养污染质量指标数据,对全国、各省份和不同等级医院结果进行统计分析,同时用西格玛度量评价实验室质量水平。结果2016—2020年全国和三级医院血培养污染率中位数整体呈现下降趋势。全国最高0.53%,最低0.00%;三级医院最高0.91%,最低0.54%;二级和其他医院近5年中位数均为0.00%。按照省份对2019和2020年三级医院中位数进行排序,结果显示黑龙江、吉林、辽宁、江西、内蒙古、宁夏、青海、甘肃和新疆生产建设兵团中位数较低。结论目前国内微生物实验室血培养情况乐观,实验室仍需加强血培养污染率质量指标监测,严格执行临床微生物实验室血培养操作规范,持续改进。

Objective To analyze retrospectively the results of external quality assessment(EQA)for quality indicators of blood culture contamination rate from 2016 to 2020 to understand the situation of blood culture in domestic microbiology laboratories,and provide reference for establishing preliminary quality standards in microbiology laboratories.Methods The National Center for Clinical Laboratories organized the Centers for Clinical Laboratories from 31 provincial(autonomous regions and municipalities directly)and Xinjiang Production and Construction Corps to launch a synchronous quality indicators-EQA program,and the collected data were reported via developed online Client-EQA system.The essential information from the clinical laboratories and the data of quality indicators of blood culture contamination rate from 2016 to 2020 were collected.The statistical analysis was conducted according to nationwide overall,province and hospital levels.Sigma values were also calculated to assess the quality levels of laboratory.Results From 2016 to 2020,the median of blood culture contamination rate in China and tertiary hospitals showed an overall downward trend.The highest was 0.53%and the lowest was 0.00%in the whole of China,and the highest was 0.91%and the lowest was 0.54%in tertiary hospitals.The median of the last five years was 0.00%in both secondary and other hospitals.Ranking the median of tertiary hospitals by province during 2019 and 2020,the results showed that Heilongjiang,Jilin,Liaoning,Jiangxi,Inner Mongolia,Ningxia,Qinghai,Gansu and Xinjiang Production and Construction Corps presented low medians.Conclusion The situation of blood culture in domestic microbiology laboratory is optimistic during the recent period.The laboratories still need to strengthen the monitoring of quality indicator of blood culture contamination rate.The strict implementation of operating procedures for blood culture and continuous improvement should be worthy of attention in clinical microbiology laboratories.