국내 임상미생물 검사실에서의 혈액배양지침 조사
Nationwide Survey of Blood Culture Protocol in Clinical Microbiology Laboratories in Korea
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배경: 혈액배양검사에서 세균의 분리는 여러 가지 요인에 영향을 받는다. 따라서, 신뢰할 수 있는 배양결과를 얻기 위해서는 혈액배양의 표준화가 반드시 필요하다. 본 연구는 최근 국내 임상미생물 검사실의 혈액배양검사 지침을 조사하여 비교 분석하였다. 방법: 검사실에서 시행하고 있는 술기와 지침에 관한 설문지를 작성 후 전국의 임상미생물 검사실을 책임자로부터 전자메일로 자료를 수집하였다. 총 18개 병원의 응답은 2014년 5월을 기준으로 작성되었다. 결과: 혈액배양 양성률에 가장 영향이 큰 혈액량도 어른인 경우 10개 병원에서는 10 mL, 5개 병원에서는 20 mL의 채혈을 권고하고 있었고, 몸무게가 14-36 kg의 어린이인 경우 8개 병원에서는 10 mL, 7개 병원에서는 5 mL 이하의 채혈을 권고하고 있었다. 신생아의 경우 12개 병원에서 1 mL 이하를 권고하고 있었다. 결론: 미생물 검사실마다 혈액배양의 술기와 지침은 상당한 차이가 있어 혈액배양에 대한 표준화된 지침이 필요한 것으로 판단하였다.
Abstract
Background: The recovery of bacteria from blood can be affected by many factors. Standardization of blood culture methods is important for reliability. Herein, we aimed to investigate blood culture protocols in Korea. Methods: We performed a multicenter survey with a questionnaire about blood culture practices, which was sent by email to directors and clinical physicians in charge of clinical microbiology laboratories in May 2014. Total data from 18 participating hospitals were analyzed to be used as current baseline data, which is necessary to optimize blood culture protocols. Results: Many laboratories included recommended blood volume, which is a major factor for bacteria recovery rate. This varied across participating laboratories. For adults, blood sampling of 10 mL was recommended by 10 laboratories and 20 mL was recommended by 5 laboratories. For children who weighed 14-36 kg and less than 14 kg, blood sampling of 10 mL (n=8) and 5 mL (n=7) was recommended, respectively. For neonates, less than 1 mL was recommended by 12 laboratories. Conclusion: Substantial variations in blood culture protocols were seen across participating clinical microbiology laboratories. Efforts to standardize this protocol should be undertaken.
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