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抽象的な：
2009年から2017年までの回顧的観察では、菌血症の病因パターンが特定されました。割り当てられた期間のみで、3週間から18歳までの515人の患者の血液培養から655の病原体が培養されました。研究結果によると、グラム陰性菌の割合は31.7％、グラム陽性菌は61.9％、真菌は6.4％でした。真菌血症は、すべての良好な血液培養の2.2％（2013年）から14.7％（2010年）までのさまざまな年に記録されました。カンジダパラプシロシスは、病原体（64.3％）とTorulopsis属の27例（64.3％）に分類されています。分離された細菌の中では、ブドウ球菌が最も多く（41%）、分離頻度の第2位は非発酵性細菌（16.7%）、第3位は腸内細菌科の細菌（14.1%）、第4位は連鎖球菌（10.8%）でした。腸内細菌科（n=86）内のグラム陰性細菌のスペクトルは、大腸菌 – 10.5%、サルモネラ – 5.8%、赤痢菌 – 25.6%、プロテウス・ミラビリス – 1.15%、プロビデンシア・スチュアルティ – 1.15%、セラチア – 15.1%、クレブシエラ – 27.9%、エンテロバクター – 10.5%、その他 – 2（2.3%）と多様です。グラム陰性非発酵細菌は、菌血症の102件（16.7%）で分離された。その中では、アシネトバクターが47.1%、シュードモナスが20.6%、アクロモバクターが12.7%、ステノトロフォモナス・マルトフィリアが7.8%と多かった。グラム陽性細菌（n=404）の分類はブドウ球菌（62.1%）によって決定され、最も頻繁に分離されたのはコアグラーゼ非感受性型（84.5%）であった。すべてのブドウ球菌（n=251）のうち、S. Aureusが15.1%の頻度で検出され、最も多かったのはS. Dermisで、症例の63.3%であった。連鎖球菌（n=66）は、Str. Pneumonia（27.3%）とStr.腸球菌は 31 人の患者 (5.1%) から分離され、Enterococcus faecalis と Enterococcus faecium (それぞれ 41.9% と 38.7%) がほぼ同頻度で優勢でした。研究期間中、Corynebacterium 属の菌株が 7 つ (1.1%) 分離されました。
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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