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脓毒症患者血培养诊断的基础设施与当前实践:欧洲脓毒症护理调查的经验教训与建议

Infrastructure and current practice of blood culture diagnostics in patients with sepsis: teachings and recommendations from the European Sepsis Care Survey.

作者信息

Scheer Christian S, Annane Djillali, Artigas Antonio, Linder Adam, Sander Michael, Demirkiran Oktay, Reinhart Konrad, Giamarellos-Bourboulis Evangelos J

机构信息

Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, University Medicine Greifswald, Greifswald, Germany.

Service de Réanimation, Comprehensive Sepsis Centre PROMETHEUS, Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, Université Versailles Saint-Quentin, Garches, Versailles, France.

出版信息

Crit Care. 2025 Aug 5;29(1):345. doi: 10.1186/s13054-025-05582-6.

Abstract

INTRODUCTION

The recently published European Sepsis Care Survey (ESCS) by the European Sepsis Alliance (ESA) showed that the standard-of-care strategies regarding infrastructure and logistics on diagnosis and management of sepsis were beyond what is considered satisfactory. This led to a position statement by the Steering Committee of the ESA.

METHODS

A literature search was conducted to compare the compliance with the Surviving Sepsis Campaign Guidelines and/or other medical societies reported by the health care practitioners participating in the ESCS regarding first line fluids and vasopressors, biomarkers, continuous availability for microbiology service and antibiotic stewardship team.

RESULTS

In all suggested practices for sepsis care the feedback of the health-care professionals who completed the ESCS showed that the average adherence was more than 80% with two exceptions: availability of microbiology diagnosis limited to 10% and antibiotic stewardship for the selection of the most appropriate antibiotic limited to 65%.

CONCLUSIONS

ESA suggests that quality measures are applied across Europe towards the implementation of bundles for early sepsis recognition, antibiotic stewardship for sepsis patients and availability of a continuous microbiology service on a 24-hour basis including weekends for timely diagnosis.

摘要

引言

欧洲脓毒症联盟(ESA)最近发布的欧洲脓毒症护理调查(ESCS)显示,脓毒症诊断和管理方面的基础设施及后勤照护标准策略未达令人满意的程度。这促使ESA指导委员会发布了一份立场声明。

方法

进行文献检索,以比较参与ESCS的医疗从业者报告的关于一线液体和血管加压药、生物标志物、微生物学服务的持续可及性以及抗生素管理团队方面,与《拯救脓毒症运动指南》和/或其他医学学会的合规情况。

结果

在所有脓毒症护理建议措施方面,完成ESCS的医护人员反馈显示,平均依从率超过80%,但有两个例外:微生物学诊断的可及性仅为10%,以及脓毒症患者选用最合适抗生素的抗生素管理依从率仅为65%。

结论

ESA建议在全欧洲实施质量措施,以落实早期脓毒症识别集束化治疗、脓毒症患者的抗生素管理,以及包括周末在内24小时不间断的微生物学服务可及性,以便及时诊断。

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