패혈증 진단을 위한 혈액배양 검사의 표준 지침 및 질향상을 위한 전국 현황 조사

초록

Background: Sepsis is a leading cause of mortality, and its diagnosis relies on accurate blood cultures. Standardizing the blood culture process is essential, therefore the nationwide survey of blood culture practices is crucial. With advancements in diagnostics, some institutions have adopt- ed rapid bacterial identification and antibiotic susceptibility testing. Methods: An electronic survey titled “Survey for Quality Improvement in Blood Culture” was conducted from July to August 2024. The survey covered five key areas: (1) laboratory operations and general information, (2) blood collection for blood culture, (3) skin disinfection, positivity and contamination rate, (4) blood culture methods, rapid bacterial identification, rapid antibiotic susceptibility testing, and (5) blood culture bottles, in- struments, and result reporting. A total of 68 institutions responded to the survey, and the data were analyzed. Results: Eleven institutions (16.2%) operated 24-hour microbiology laboratories on weekdays, and 32.4% had dedicated phlebotomy teams. Skin disinfection methods varied; excluding referral medical laboratories, 32.8% used either a combination of povidone-iodine and alcohol or chlorhexidine gluconate with alcohol. The median blood culture positivity and contamination rate were 7.90% and 1.23%, respectively. Rapid iden- tification and rapid susceptibility testing were implemented in 36.8% and 16.2% respectively. Conclusions: The survey revealed substantial variability in blood culture practices across institutions, with some adopting rapid bacterial identi- fication and/or rapid antibiotic susceptibility testing technologies. To enhance the management of sepsis, the establishment of standardized guide- lines and continued quality improvement of blood cultures is essential.

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