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发表于 2008-3-26 12:15
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论试译：CONCLUSION
Clearly, progress has been made on several fronts in the battle against blood culture contamination.（显然，在应对血培养污染问题上已经取得了一些进展。） Better strategies for preventing contamination in the first place are being established, and we are improving our ability to distinguish contamination from true bacteremia. （我们阐明了更好的预防血培养污染的策略，并且也改进了区分污染菌和致病菌的能力。）New research on measures to estimate the pretest likelihood of bacteremia offers promise in reducing unnecessary blood culture utilization. （新的研究估计了可能产生菌血症的阈值，提供给我们一种减少不必要血培养的前景。）Despite the progress that has been made, however, significant barriers remain. （尽管目前仍在进行试验，但有意义的阈值是存在的。）Without a gold standard for truly distinguishing contaminant organisms from true pathogens, studies that seek to measure the success of prevention strategies are inherently limited. （由于目前还没有一个区分污染菌和致病菌的金标准，本质上限制了寻求成功的预防策略的相关研究。）Similarly, efforts to help establish the posttest probability of bacteremia given a positive result are restricted. （与之相似，由于阳性结果受到限制，菌血症的检测效果不能很好的阐明。）Genomic and proteomic approaches for identifying bacteremia are being explored but remain in the early stages (96, 122, 123). （用基因组和蛋白质组来鉴别菌血症的研究还在早期探索中。）There is evidence, however, to suggest that even these methods can be hampered by problems with contamination (95). （然而，有证据表明甚至这些方法也有可能妨碍问题的解决。）Furthermore, additional research on the value of time to positivity and quantity of growth for differentiating culture contamination from bacteremia is necessary. （另外，有必要进一步研究区分血培养污染菌的生长时间和数量。）Of the various prevention strategies, additional investigation would help to determine the relative effect of each strategy on overall contamination rates. （在多种预防策略中，额外的调查有助于决定每个策略的相对价值。）In the meantime, information technology may have a role in facilitating the detection of contamination, assisting clinical decisionmaking, and enabling better systems for tracking contamination rates both within and between institutions. （同时，信息技术可以促进污染的正确检测，帮助临床判断，以及开发更好的系统来追踪医院内和医院之间的污染轨迹。）Additional research on how to make these tools more useful and more acceptable in the clinical work environment is needed. （此外还需要研究如何使这些工具在临床工作环境下更有用更易于接受。）Similarly, while clinical prediction rules for bacteremia have received much scrutiny in the past 15 years, it remains unclear whether they perform at a level that is accurate enough to influence physician behavior and affect blood culture utilization. （与之相似，尽管临床预报菌血症的规则在过去15年中已经得到详细的审查，但仍然存在很多不明确的地方，如是否存在一个足够准确以至影响医生使用血培养作为诊断方法的感染水平。）More research is needed to refine these models and test them in other settings. （需要更多的实验来改进这些模型并且在其他地方测试其准确性。）In the pediatric arena, additional studies are clearly needed to help physicians interpret the results of single blood cultures that grow coagulase-negative staphylococci, a persistent challenge. （在儿科领域，很明显还需要解释一个一直存在的难题，那就是如何解释单一血培养生长出凝固酶阴性的葡萄球菌。）Ultimately, blood culture contamination is a complex, challenging problem that requires a multidisciplinary approach. （最后，血培养污染问题是一个复杂的需要多学科共同应对的挑战。）Well-conceived and effectively implemented strategies are important for reconciling the sometimes contradictory requirements of individual patient care, population health, and effective resource allocation. （精心设计的有效执行的策略很重要，从而调和单一病人护理，公众健康和资源利用之间有时出现的需求矛盾。）
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