进行血培养选择哪种消毒剂所致污染最少？有一个系统评价

楚楚

J Hosp Infect. 2011 Mar;77(3):223-32. Epub 2010 Dec 30.

Skin antiseptics in venous puncture-site disinfection for prevention of blood culture contamination: systematic review with meta-analysis.

Caldeira D, David C, Sampaio C.

Source

Clinical Pharmacology and Therapeutics Laboratory, Faculty of Medicine, Lisbon, Portugal. dgcaldeira@hotmail.com

Abstract

Blood cultures drawn by venous puncture are common clinical procedures for the detection of bacteraemia. Blood culture contamination (BCC) can lead to clinical misinterpretation and unnecessary expenses. We aimed to systematically review randomised controlled trials (RCTs) with skin antiseptics for prevention of contamination in venous-puncture drawn blood cultures. We conducted database search using CENTRAL (Cochrane Library issue April 2010), MEDLINE, EMBASE and mRCT, in June 2010. All RCTs testing skin antiseptics in venous-puncture drawn blood cultures were retrieved. Relative risk (RR) of the BCC outcome was analysed by random effects method using confidence interval (CI) of 95%. Studies were assessed by one review author and checked by another. Six studies were identified. Single-trial comparisons showed that alcoholic iodine tincture was better than non-alcoholic povidone-iodine, and isopropyl/acetone/povidone-iodine showed superiority against isopropyl/povidone-iodine. Meta-analysis demonstrated that alcoholic chlorhexidine was better than non-alcoholic povidone-iodine (RR: 0.33; 95% CI: 0.24-0.46) in 4757 blood cultures from two trials. Alcoholic solutions were better than non-alcoholic products (0.53; 0.31-0.90) in 21,300 blood cultures from four studies. Two trials with 13,418 blood cultures showed that iodine tincture was not superior to povidone-iodine in BCC prevention (0.79; 0.54-1.18). Alcoholic iodine was not different from non-alcoholic iodine (0.79; 0.53-1.17). Comparison of chlorhexidine vs iodine compounds was not conclusive. Alcohol alone was not inferior to iodinated products for prevention of contamination in venous-puncture drawn blood cultures. The association of alcohol and povidone-iodine did not seem to be useful. Alcoholic chlorhexidine solutions reduced blood culture false positives compared with aqueous povidone-iodine.

Copyright © 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

该文对血培养采用哪种消毒剂最好进行了Meta分析，结论是洗必泰酒精最好。

细菌耐药

看看老外的科研选题，即简单又实用，这是我们需要学习的地方。

四叶草

多谢楚管，学习了。血培养污染率较高，皮肤消毒剂的选用很重要，可以减少污染。只是洗必泰酒精不知国内有没有售？

放飞梦想

上传全文，便于大家进一步阅读。
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风子一平

感谢楚楚管理员的资料及放飞梦想版主上传全文。

agatha328

谢谢！好文共分享啊，别人怎么总能想出一些好点子呢

chm0007

好文共分享啊下载学习