Effect of postmortem sampling technique on the clinical significance of autopsy blood cultures
Effect of postmortem sampling technique on the clinical significance of autopsy blood cultures
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DOI：
10.1016/s0046-8177(98)90223-4
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发表时间：
1998-02-01
期刊：
影响因子：
3.3
通讯作者：
Pencil, SD
中科院分区：
文献类型：
--
作者：
Hove, M;Pencil, SD
我们的目的是调查的价值，尸检血培养进行了碘锁骨下技术相对于心房热灼和死前血培养的经典方法。该研究包括一个前瞻性尸检系列，每个病例作为其自身的对照，相对于随后的测试，和一个回顾性调查的病人来尸检谁尸检血培养和死前血培养。德克萨斯州加尔维斯顿的德克萨斯大学医学分支医院的一个忙碌尸检服务（每年600例）是这项工作的背景。在一个前瞻性系列的38例成人尸检标本中，使用不同的血液样本采集方法比较了非临床相关（假阳性）培养结果的发生率。回顾性研究了111例成人尸检标本，其中包括死后和死前血培养。对于这两项研究，根据尸检结果和临床总结的分析，将阳性培养结果评分为临床相关或假阳性。在同一组尸检受试者中，通过碘-锁骨下技术从死亡后不久抽取的血液中获得的假阳性培养结果的发生率（13%）在统计学上显著低于使用经典方法在尸检时热烧灼后通过心房获得血液（34%）。当尸检结果与受试者的死前血培养结果进行比较时，在使用碘-锁骨下死后方法的死前血培养和死后血培养的配对回顾性系列中，非临床相关培养结果的比率没有显著差异（11.7%对13.5%）。结果表明，使用碘锁骨下技术获得的尸检血培养具有与死前血培养相同的可靠性。版权所有（C）1998由W.B.桑德斯公司
Our objective was to investigate the value of postmortem autopsy blood cultures performed with an iodine-subclavian technique relative to the classical method of atrial heat searing and antemortem blood cultures. The study consisted of a prospective autopsy series with each case serving as its own control relative to subsequent testing, and a retrospective survey of patients coming to autopsy who had both autopsy blood cultures and premortem blood cultures. A busy academic autopsy service (600 cases per year) at University of Texas Medical Branch Hospitals, Galveston, Texas, served as the setting for this work. The incidence of non-clinically relevant (false-positive) culture results were compared using different methods for collecting blood samples in a prospective series of 38 adult autopsy specimens. One hundred eleven adult autopsy specimens in which both postmortem and antemortem blood cultures were obtained were studied retrospectively. For both studies, positive culture results were scored as either clinically relevant or false positives based on analysis of the autopsy findings and the clinical summary. The rate of false-positive culture results obtained by an iodine-subclavian technique from blood drawn soon after death were statistically significantly lower (13%) than using the classical method of obtaining blood through the atrium after heat searing at the time of the autopsy (34%) in the same set of autopsy subjects. When autopsy results were compared with subjects' antemortem blood culture results, there was no significant difference in the rate of non-clinically relevant culture results in a paired retrospective series of antemortem blood cultures and postmortem blood cultures using the iodine-subclavian postmortem method (11.7% v 13.5%). The results indicate that autopsy blood cultures obtained using the iodine-subclavian technique have reliability equivalent to that of antemortem blood cultures. Copyright (C) 1998 by W.B. Saunders Company.