血培养在血流感染中作用和最佳操作BestPracti.pptxVIP

血培养在血流感染中作用和最佳操作;大纲;BLOOD CULTURES血培养; Hectic fever (sepsis) at its inception is difficult to recognize but easy to treat, left untended,it becomes easy to recognize but difficult to treat. 痨病热（败血症）在起初辨别起来很困难，但是治疗很容易；但现在它已经变为辨别很容易但治疗十分困难。 - Machiavelli The Prince, circa ;“One of the most important functions of the diagnostic microbiology laboratory.” 微生物实验室诊断是最重要的手段之一。;菌血症和真菌血症----直接威胁生命的感染性疾病;一过性菌血症（Transient bacteremia）;一过性菌血症（Transient bacteremia）;持续性菌血症 （Continuous bacteremia）;间歇性菌血症（Intermittent bacteremia）;Sepsis : Worldwide and US败血症：全球和美国;定义：感染所导致的系统性炎症反应有如下表现： 发热/体温过低 心率加快 呼吸加快 白血病增多/降低 并随着病程发展而发展; ;Blood Cultures to Detect Sepsis血培养检测败血症;Epidemiology of Bloodstream Infections血流感染的流行病学;TOP 10 CLINICALLY-SIGNIFICANT MICROORGANISMS 有临床意义的前10位细菌(1990-1993): CID 1997;Top Ten Blood Culture Isolates (1996-1997)前10位血培养分离的菌株（1996－1997）; ;怀疑感染病人的经验性抗感染治疗Empirical Therapy in Suspect Patient;使经验治疗更加有效;经验性抗感染治疗的依据Basis for Empirical Therapy;Shanson, 1990;Adapted from Phillips et al., 1990;Winchester et al., 1977;Detection of Positive BC阳性血培养的检测;Clinical Case History临床病例举例;Clinical Impact of Case #11号病例的临床效果;“Do Positive Blood Cultures affect Therapy and Mortality?”“阳性血培养能改善治疗降低死亡率吗？”;OUTCOME ACCORDING TO THERAPY不同治疗的结局;Optimal Recovery of Organisms in Blood Culture血培养的最佳检出率;Key Points（关键点）;“When is the best time to draw blood cultures on a patient with suspected sepsis?”怀疑败血症患者采集血培养的最佳时间？;0;What is the best time to draw blood cultures?采集血培养的最佳时间？;“How many blood culture sets do I need to draw?”需要采集多少份血培养？;NUMBER OF SETS;Cockerill, CID 2021;How many blood culture sets should be drawn?应该采集多少份血培养？;CLINICAL SIGNIFICANCE OF Staphylococcus epidermidis表皮葡萄球菌的临床意义;How far apart should the sets be collected?每次采集血培养的间隔时间？;“How much blood should I draw from the patient?”患者应采集多少血液？;Effect of Volume血液量的影响;How much blood should be drawn for blood culture?应采集多少血液？;“The patient is already on antibiotics, would resin-based media help to recover the organism