謝爾希延卡 CN
抽象的：
2009年至2017年的回顧性觀察轉變為研究確定的菌血症病因模式。僅針對從年齡從 3 週到 18 歲的 515 名患者的血液培養物中培養出的 655 種病原體的長度。根據檢測結果，革蘭氏陰性菌比例為31.7%，革蘭氏陽性菌為61.9%，真菌為-6.4%。真菌血症在所有優良血液培養中的比例從 2.2%（2013 年）到 14.7%（2010 年）不等。近平滑念珠菌（Candida parapsilosis）在球擬酵母屬（Torulopsis）病原體（64.3%）和 27 例（64.3%）的病原體結構內盛行。分離微生物中，以葡萄球菌為主（41%），分離頻率第二位由非發酵微生物佔據（16.7%），第三位為腸桿菌科微生物（14.1%）。 – 鏈球菌(10.8%)。腸桿菌科內的革蘭氏陰性微生物譜（n=86）多元：埃希氏菌– 10.5%、沙門氏菌– 5.8%、志賀氏菌– 25.6%、奇異變形桿菌– 1.15%、普羅維登斯登斯氏菌– 1.15% ，沙雷氏菌 – 15.1%，克雷伯氏菌 – 27.9%，腸桿菌 – 10.5% 和其他 – 2（2,3%）。在 102 次（16.7%）菌血症中分離出革蘭氏陰性非發酵細菌。其中以不動桿菌占主導，佔47.1%，假單胞菌佔20.6%，無色桿菌佔12.7%，嗜麥芽寡養單胞菌佔7.8%。革蘭氏菌(n=404)的結構以葡萄球菌(62.1%)為主,其中以凝固酶類最多(84.5%)。在所有葡萄球菌 (n=251) 的形態中，金黃色葡萄球菌的出現頻率為 15.1%，最常見的是真皮葡萄球菌，佔 63.3%。鏈球菌 (n=66) 已以 Str. 的方式進行控制。肺炎 (27.3%) 和鏈球菌。 Agalacia (19.7%) 和 Str.草綠色群體（15.2%）。在 31 名患者（5.1%）中分離出腸球菌，其中以糞腸球菌和屎腸球菌（分別為 41.9% 和 38.7%）為主的頻率幾乎相同。研究期間，分離出 7 株（1.1%）棒狀桿菌屬菌株。
Blood cultures continue to be the mainstay of laboratory diagnosis of bloodstream infections (BSIs) in babies and youngsters. Recovery of a pathogen is effective, because it confirms the prognosis of bacteremia and allows for identity and susceptibility trying out at the organism to optimize antimicrobial therapy and length. A bad blood subculture is simply as critical, because it regulations out cases of bacteremia and prompts continued research of different infectious or noninfectious etiologies or cessation of useless empirical antimicrobial therapy.
The majority of research related to the laboratory diagnosis of BSI cognizance at the person populace. Thus, this minireview can be committed to kids and the multifactorial factors worried in obtaining an most excellent pediatric blood tradition specimen, consisting of timing, quantity, and bottle selection. Lastly, a discussion on the rapid diagnostic strategies presently to be had and their impact on pediatric control and results will be reviewed.
The two above studies mentioned correlation among blood cultures that were fantastic with noncontaminant micro-organism and ok blood extent (prevalence rates of 60% to 71%). In comparison, the research determined that procurement of low blood quantity inversely correlated with blood tradition infection fees. 60-5 percent of effective blood cultures deemed to be contaminants had insufficient blood volume, and restoration of contaminant turned into two times as probably while inadequate blood volume became obtained (5.1% versus 2.8%). These findings further aid the need of acquiring enough blood tradition volume, as the recovery of contaminants has been suggested in 25% to 69% of all fantastic blood cultures in pediatric patients and is associated with needless antimicrobial therapy, prolonged hospitalization, and incurred cost. It isn't in particular clean why low extent blood cultures are more prone to yield contaminants; one idea is that the purchase of contaminants is unbiased of blood extent, and as a substitute the collection of larger blood extent dilutes the awareness of the contaminant present inside the blood subculture bottle, lowering the danger of detection at some point of the incubation duration.
In conclusion, there are restricted records to set up the top-rated series quantity in children, and most people of records is extrapolated from research in grownup populations. A safe and suitable technique is that the collection of blood ought to be proportionate to the patient's total blood quantity and, greater specifically, the affected person's weight. There is a lack of consensus among the present day pointers for pediatric blood collection. The maximum current suggestions from the Infectious Diseases Society of America (IDSA) and the American Society of Microbiology (ASM) advocate the collection of 3% to 4% of overall affected person blood quantity in sufferers weighing <12.7 kg and 1.8% to 2.7% in patients weighing>12.8 kg
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