Detailed Analysis of the Characteristics of Sample Volume in Blood Culture Bottles
Detailed Analysis of the Characteristics of Sample Volume in Blood Culture Bottles
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DOI：
10.1128/jcm.00268-19
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发表时间：
2019-08-01
影响因子：
9.4
通讯作者：
Ozenci, Volkan
中科院分区：
文献类型：
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作者：
Henning, Claes;Aygul, Nilsu;Ozenci, Volkan
血容量是检测血培养（BC）中微生物的最重要变量。大多数标准建议40至60毫升的血液，收集在几个BC瓶填充多达10毫升。我们测量了单个BC瓶中的血容量，并分析了医院、瓶类型、星期几、每日采样时间以及患者的年龄和性别与采样量和BC结果的关系。在混合线性模型中分析了每个BC瓶的血量变化，该模型使用医院、瓶类型、工作日、采样时间、年龄和性别作为固定因素，患者识别（ID）和发作作为随机因素，以控制个体患者的重复采样。只有18%的瓶子填充了推荐的8到10毫升，47%的瓶子填充了不到8毫升。阳性培养瓶的平均（+/-标准误差）体积（9.09 +/- 0.15）大于阴性培养瓶（8.47 +/- 0.07）（P < 0.001）。BacT/Alert-FA Plus培养瓶的血容量大于-FN Plus BC培养瓶（P < 0.001）。夜间采集的体积显著较低（P < 0.001）。随着年龄的增长，采血量明显减少（P < 0.001）。从男性患者中采集的体积大于从女性患者中采集的体积：分别为8.78（+/- 0.06）和8.36（+/- 0.06）ml（平均值+/-标准误[SE]）（P < 0.001）。每多抽取一毫升血液，检测出阳性患者的几率就增加13%。我们的研究结果表明，我们需要积极努力，制定血液采样程序，以克服年龄和性别的影响，并优化血液采样量。
Blood volume is the most important variable for the detection of microorganisms in blood cultures (BCs). Most standards recommend 40 to 60 ml blood, collected in several BC bottles filled up to 10 ml. We measured blood volume in individual BC bottles and analyzed the associations of hospital, bottle type, day of the week, daily sampling time, and age and sex of the patient with sampling volume and BC result. The variation in blood volume per BC bottle was analyzed in a mixed linear model using hospital, bottle type, weekday, sampling time, age, and sex as fixed factors and patient identification (ID) and episode as random factors to control for repetitive sampling of individual patients. Only 18% of all bottles were filled with the recommended 8 to 10 ml, and 47% were filled with less than 8 ml. The mean (+/- standard error) volume was larger in positive bottles (9.09 +/- 0.15) than in negative bottles (8.47 +/- 0.07) (P < 0.001). Blood volume was larger in BacT/Alert-FA Plus bottles than in -FN Plus BC bottles (P < 0.001). There were significantly lower volumes collected during the night (P < 0.001). The volume of blood collected decreased significantly with increasing patient age (P < 0.001). Larger volumes were collected from male patients than from female patients: 8.78 (+/- 0.06) versus 8.36 (+/- 0.06) ml (mean +/- standard error [SE]), respectively (P < 0.001). The odds of detecting a positive patient increases by 13% for each additional milliliter of blood drawn. Our results show that we need to work actively with the development of blood sampling routines to overcome age and sex effects and to optimize blood sampling volumes.