Defining System Requirements for Simplified Blood Culture to Enable Widespread Use in Resource-Limited Settings
Defining System Requirements for Simplified Blood Culture to Enable Widespread Use in Resource-Limited Settings
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DOI：
10.3390/diagnostics9010010
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发表时间：
2019-01-11
期刊：
影响因子：
3.6
通讯作者：
Dittrich, Sabine
中科院分区：
文献类型：
--
作者：
Dailey, Peter J.;Osborn, Jennifer;Dittrich, Sabine
细菌性血流感染（BSI）是全球死亡和发病的常见原因。由于病原体和由此产生的治疗决定各不相同，因此有必要使用近患者检测和监测工具来监测细菌原因和对抗菌剂的耐药性。确定BSI的金标准是血培养（BC），这是一种在资源有限的环境中不广泛使用的方法。该研究的目的是绘制出一个简化的BC系统（SBCS）的目标产品概况，为产品开发工作提供信息。为了确定SBCS的理想特性，我们招募了一个在非洲和亚洲工作的专家小组。问题用于了解挑战以及这些约束如何告知系统需求。这些专家是具有不同地理背景的传染病医生、公共卫生/临床微生物学家、临床研究人员和技术专家。所有人都建议，最好在地区医院一级提供业务连续性。在不同地区发现了许多相同的运营挑战，例如培养瓶、电力和互联网连接有限、灰尘多、缺乏环境温度控制以及人力资源限制。尽管BCs是公认的诊断BSI的金标准，但在非洲和亚洲的参考/研究中心之外并不广泛。为了扩大这一重要工具的覆盖范围，至关重要的是让产品开发人员和学术研究伙伴参与开发可访问的替代品。
Bacterial blood stream infections (BSI) are a common cause of mortality and morbidity globally. As the causative agents and the resulting treatment decisions vary, near-patient testing and surveillance tools are necessary to monitor bacterial causes and resistance to antimicrobial agents. The gold standard to identify BSIs is blood culture (BC), a methodology not widely available in resource-limited settings. The aim of the study was to map out a target product profile of a simplified BC system (SBCS) to inform product development efforts. To identify the desired characteristics of a SBCS, we enlisted a small group of specialists working in Africa and Asia. Questions were used to understand challenges and how these constraints inform system requirements. The specialists were infectious disease physicians, public health/clinical microbiologists, clinical researchers, and technology experts with different geographical backgrounds. All suggested that BC should ideally be available at the district hospital level. Many of the same operational challenges, such as limited availability of culture bottles, electricity and internet connectivity, profuse dust, the lack of ambient temperature control, and human capacity constraints were identified across the different regions. BCs, although the accepted gold standard for diagnosis of BSIs, are not widely available outside of reference/research centers in Africa and Asia. To extend the reach of this important tool, it is crucial to engage product developers and academic research partners to develop accessible alternatives.