临床微生物室在抗感染目标治疗中的作用_培训课件.pptVIP

* * * * * * * * * * 1) The first level is a simple statement indicating the reason for the alert. * Second and third levels offer additional assistance to technologists as test results are reviewed. 2) A symbol indicating the priority setting for the alert, high, medium or low, accompanies the alert statement in the review and edit mode * 3) Expandable, instructional text reflecting laboratory-specific operating practices can be easily accessed during results review. For example: Always confirm result Report if previously tested with same result Contact Infection Control * You can print a panel alert report and distribute back to the bench for appropriate follow-up. The report provides detailed information about the condition. * * * * The presence of some organisms, such as Propionibacterium acnes, in blood culture is unlikely to indicates true bacteremia, unless the patient is at special risk. The presence of some organisms, such as Staphylococcus aureus, should be assumed to indicate true bacteremia unless proven otherwise. Identification of coagulase-negative staphylococci in blood is one of the major reasons for vancomycin use in the United States, but most often these organisms are contaminants. The first step to interpret blood culture results when coagulase-negative staphylococci are identified is to assess the pre-test probability of true bacteremia. Some patients, including those with endovascular implants and other prosthetic devices, are at increased risk for coagulase-negative staphylococcal bacteremia. Likewise, neutropenic patients are at increased risk. Vascular catheters also increase the risk, but most coagulase-negative cultures in catheterized patients without other risk factors are contaminants. In patients who are critically ill, treatment is usually indicated until true bacteremia is excluded in the differential diagnosis. Additional information can help assess the post-test probability of true bacteremia. If more than one specimen