Análisis de una estrategia de toma de hemocultivos basada en venopunción única

IF 2.2 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI:10.1016/j.eimc.2026.503105

Adelina Gimeno Gascón , José Molina Gil-Bermejo , Francisco Trigo Sorroche , M. Carmen Navarro Navarro , Manuela Aguilar Guisado , Germán Peñalva Moreno , Ana Belén Guisado Gil , Claudio Bueno Mariscal , José Miguel Cisneros Herreros , José Antonio Lepe Jimenez

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引用次数: 0

Abstract

Introduction

Blood volume is the main determinant of blood culture diagnostic yield. Although guidelines recommend obtaining at least two complete sets, the traditional multiple extraction (ME) strategy requires two venipunctures, whereas the single extraction (SE) strategy uses one venipuncture to inoculate all four bottles. The aim of this study was to evaluate the impact of SE on the diagnostic performance of blood cultures in a high-demand emergency department.

Methods

A quasi-experimental observational study with a before-after design was conducted. The SE protocol was implemented in March 2023. Three periods were analyzed: pre-intervention (2022, ME), post-intervention (April 2023–March 2024, SE), and follow-up (June 2024–May 2025, SE). Blood cultures were processed using BD BACTEC™ FX, and data were retrieved from BD EpiCenter™ and the laboratory information system.

Results

A total of 4,614 blood cultures from 3,206 patients were analyzed in the pre-intervention period and 4,974 cultures from 3,756 patients in the post-intervention period. After SE implementation, solitary cultures decreased significantly (85.9% to 7.2%) and contamination rates dropped (6.5% to 3.5%) (p < 0.05). True bacteremias increased slightly (16.2% to 17.4%) without statistical significance. Improvements were sustained in the follow-up period, with contamination rates reaching 2.5% and falling for the first time below the 3% quality threshold.

Conclusions

The SE strategy improves blood culture quality by significantly reducing solitary and contaminated samples without compromising the detection of true bacteremias. Its implementation may optimize diagnostic performance and promote more rational use of resources in high-pressure emergency settings.

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单次静脉注射血液培养策略分析

血容量是血培养诊断产率的主要决定因素。尽管指南建议至少获得两套完整的疫苗，但传统的多次提取（ME）策略需要两次静脉穿刺，而单次提取（SE）策略使用一次静脉穿刺来接种所有四个瓶子。本研究的目的是评估SE对高需求急诊科血液培养诊断性能的影响。方法采用事前-事后设计的准实验观察研究。SE协议于2023年3月实施。分析了三个时期：干预前（2022年，ME）、干预后（2023年4月- 2024年3月，SE）和随访（2024年6月- 2025年5月，SE）。使用BD BACTEC™FX处理血培养，数据从BD EpiCenter™和实验室信息系统中检索。结果分析了干预前3206例患者的4614份血培养物，干预后3756例患者的4974份血培养物。采用SE后，孤立培养显著减少（85.9%至7.2%），污染率下降（6.5%至3.5%）（p < 0.05）。真菌血症略有增加（16.2% ~ 17.4%），但无统计学意义。在随访期间持续改善，污染率达到2.5%，首次低于3%的质量阈值。结论SE策略通过显著减少孤立和污染样本而不影响真菌血症的检测，提高了血培养质量。它的实施可以优化诊断性能，促进高压应急环境下资源的更合理利用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.