Neonatal blood culture inoculant volume: feasibility and challenges.
Neonatal blood culture inoculant volume: feasibility and challenges.
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DOI：
10.1038/s41390-021-01484-9
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发表时间：
2021-11
影响因子：
3.6
通讯作者：
Mukhopadhyay S
中科院分区：
文献类型：
--
作者：
Woodford EC;Dhudasia MB;Puopolo KM;Skerritt LA;Bhavsar M;DeLuca J;Mukhopadhyay S
临床医生经常对接种量不足导致新生儿血培养敏感性差表示担忧。我们的目的是确定接种量发送新生儿败血症评估，并确定改进的领域。接受败血症评估的婴儿的单中心前瞻性观察研究。在21个月期间通过临床医生记录确定血容量，另外在12个月期间通过称量培养瓶来确定血容量。适当体积定义为每次评价总接种量≥1 mL。对于首次评估，当地指南建议发送一个好氧-厌氧对，每个1 mL接种剂。在788名婴儿中进行了987次评估。96.9%的评价中，临床医生报告总接种量≥1 mL。在对瓶进行称重的544项评价中，93.4%的接种物总量≥1 mL。出生后>7天接受评估的极低出生体重儿接种不足的比例最高（14.4%）。只有3/544次评价和26/1，011瓶的总接种量<0.5 mL。尽管总接种体积允许在其中一个瓶中接种≥ 1 mL，但90项评价在需氧和厌氧瓶中均<1 mL。获得推荐的接种量在大多数新生儿中是可行的。测量孕育剂体积可以集中改进工作并提高测试可靠性。
Clinicians often express concerns about poor sensitivity of blood cultures in neonates resulting from inadequate inoculant volumes. Our objective was to determine the inoculant volume sent for neonatal sepsis evaluations and identify areas of improvement. Single-center prospective observational study of infants undergoing sepsis evaluation. Blood volume was determined by clinician-documentation over 21 months, and additionally by weighing culture bottles during 12 months. Adequate volume was defined as ≥1 mL total inoculant per evaluation. For first-time evaluations, local guidelines recommend sending an aerobic-anaerobic pair with 1 mL inoculant in each. There were 987 evaluations in 788 infants. Clinicians reported ≥1 mL total inoculant in 96.9% of evaluations. Among 544 evaluations where bottles were weighed, 93.4% had ≥1 mL total inoculant. Very low birth weight infants undergoing evaluations >7 days after birth had the highest proportion of inadequate inoculants (14.4%). Only 3/544 evaluations and 26/1,011 bottles had total inoculant <0.5 mL. Ninety evaluations had <1 mL in both aerobic and anaerobic bottles despite a total inoculant volume that allowed inoculation of ≥1 mL in one of the bottles. Obtaining recommended inoculant volumes is feasible in the majority of neonates. Measuring inoculant volumes can focus improvement efforts and improve test reliability.
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发表时间：
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影响因子：
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