在2019冠状病毒病大流行期间和之后，血液培养物污染发生率增加。

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-04-01 Epub Date: 2025-03-03 DOI:10.1007/s15010-024-02469-6

Hannah Tolle, Aude Nguyen, Aleece MacPhail, Nasreen Hassoun-Kheir, Marie-Noelle Chraiti, Filippo Boroli, Marie-Céline Zanella, Stephan Harbarth, Gaud Catho, Niccolò Buetti

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引用次数: 0

摘要

目的：血液培养污染（BCC）主要是由共生菌引起的。它导致不必要的抗生素暴露、长期住院、额外的微生物检查和严重的不良健康经济负担。我们的目的是调查COVID-19大流行对BCC发病率的短期和长期影响。方法：我们在日内瓦大学医院（HUG）进行了一项回顾性观察性队列研究。我们纳入了2018年1月至2023年12月期间收集的所有bcc，这些bcc是感染控制小组在全院范围内进行前瞻性监测的一部分。使用分段泊松回归模型分析数据，评估三个时期的BCC发病率比（IRRs）： COVID-19前（2018-2019）、COVID-19期间（2020-2021）和COVID-19高峰后（2022-2023）。结果：在收集的456,873例血培养中，鉴定出1,247例bcc（0.27%）。每1000个样本的污染率从COVID-19前的1.53上升到COVID-19期间的2.94和COVID-19后的3.52。与COVID-19前相比，BCC的发病率比（IRRs）在COVID-19期间（IRR 1.84, 95% CI 1.58-2.15）和COVID-19后高峰（IRR 2.29, 95% CI 1.97-2.66）增加。在COVID-19期间，重症监护病房的BCC比例增加（27.4%,n = 127），并在COVID-19后恢复到基线水平（17.3%,n = 93, p）。结论：我们观察到BCC发病率在COVID-19高峰期间和之后显著上升。持续升高的峰值后率突出了恢复最佳无菌血培养收集实践的持续挑战，以及进一步探索增加BCC率的持续因素的必要性。

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Increased incidence of blood culture contaminations during and after the COVID-19 pandemic.

Purpose: Blood culture contamination (BCC) is mainly caused by commensal bacteria, during sample collection. It results in unnecessary antibiotic exposure, prolonged hospitalisation, additional microbiology workup and significant adverse health-economic burden. We aimed to investigate the short- and long-term impact of the COVID-19 pandemic on the incidence of BCC.

Methods: We conducted a retrospective, observational cohort study at Geneva University Hospitals (HUG). We included all BCCs from January 2018 to December 2023, collected as part of a prospective hospital-wide surveillance by the infection control team. Data were analyzed using segmented Poisson regression models to evaluate BCC incidence rate ratios (IRRs) across three periods: pre-COVID-19 (2018-2019), during COVID-19 (2020-2021), and post-COVID-19 peak (2022-2023).

Results: Out of 456,873 collected blood cultures, 1,247 BCCs were identified (0.27%). The contamination rate per 1000 samples increased from 1.53 pre-COVID-19 to 2.94 during COVID-19 and 3.52 post-COVID-19. Compared to the pre-COVID-period, incidence rate ratios (IRRs) for BCC increased during COVID-19 (IRR 1.84, 95% CI 1.58-2.15) and post-COVID-19 peak (IRR 2.29, 95% CI 1.97-2.66). During COVID-19, proportions of BCC were increased in intensive care units (27.4%, n = 127) and returned to baseline level post-COVID-19 (17.3%, n = 93, p < 0.001); whereas, in other wards, BCC remained elevated (42.2%, n = 227) in the post-COVID-19 period.

Conclusions: We observed a significant rise in BCC incidence during and after the COVID-19 peak. The persistently elevated post-peak rates highlight ongoing challenges in regaining optimal aseptic blood culture collection practices and the need for further exploration of persisting factors increasing BCC rates.

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.