Study for Efficient Blood Management Using Evaluation the Blood Wastage Statements in Pusan University Hospital / 대한수혈학회지

BACKGROUND: Efforts to reduce the wastage of blood components are necessary because of the shortage of blood components. To find ways of reducing the blood component wastage, we monitored the trends and reasons for wastage and we analyzed this data. METHODS: We have investigated and analyzed the amount and reasons for wastage from 2003 to 2005 by reviewing the wastage statements, and the information on these wastage statements was classified according to several aspects. Ouestions about the reasons for wastage and the methods for reducing such wastage were created and these were widely distributed to the doctors and nurses working at Pusan University Hospital. The results of the survey were analyzed. RESULTS: The wastage rates of blood component from 2003 to 2005 had a tendency to slightly decline: 1.49% in 2003, 1.26% in 2004 and 1.23% in 2005. The most frequent reason for wastage was the improvement in the patient's condition and the second most frequent reason was death of the patient. The favorite answers for the question about the most likely reason for wastage were related to different aspects of medicine, and also to the improvement in the patient's condition (52.6%) and the death of patient (22.6%) for the aspect of blood management, the most frequent answers were overcharge (43.3%) and delay of blood returning (17.7%). The analysis of the pattern of wastage showed that only 5 departments were responsible for 71.5%~78.1% of the wastage. CONCLUSION: Systematic and active management of the transfusion process, along with intensive cooperation of clinicians, is needed to prevent a considerable amount of blood component wastage.

Incidence of False-Positive Cultures of Mycobacterium tuberculosis in A Microbiology Laboratory / 대한임상미생물학회지

BACKGROUND: Mycobacterial false-positive cultures have rarely been recognized in Korea, even though the rate of false-positive cultures of Mycobaterium tuberculosis has ranged from 0.4% to 4.0%. We estimated the false-positive rates by the review of medical records from whom mycobacterial cultures were requested, retrospeaively, after a bout of false-positive cultures was discovered in specimens treated in a single day. METHODS: Of the total 2,245 specimens, including 337 positive cultures of mycobacteria, during the period of January and June 1999, seventy-two specimens that showed colonies less than or equal to 5 colonies were reviewed, and classified as tuberculosis-likely group, tuberculosis-unlikely group and unclassifiable group by the clinical and radiological evidences, anti-tuberculosis therapy, and microbiological results. RESULTS: Tuberculosis-unlikely group was 21 specimens from 20 patients, and unclassifiable group was five specimens from four patients. So, the false-positive rates were estimated as 0.9- 1.1% of total cultures and 6.2-7.7% of positive cultures, according to excluding or including the unclassifiable group. CONCLUSION: Care should be taken for lowering false-positive mycobacterial cultures. Especially when a culture turned out to be positive with low colony isolates, more careful interpretations should be preceded before reporting the results by the review of medical records and communication with physician in charge.

Screening of Urine Culture Specimens by Gram Stain, Urinalysis and Urine Microscopic Examinations / 대한임상미생물학회지

BACKGROUND: The purpose of this study was to discover ways to screen urine culture specimens through Gram stains, urine stick analyses and microscopic examinations for the laboratory cost saving. METHODS: One hundred and fifty-eight urine specimens for culture were included. Fifty uL of urine were inoculated onto one well each of 10-well slide, dried on the hot plate, and Gram-stained. The results combined with routine urinalyses including urine nitrite and leukocyte esterase, and pyuria, were compared with the routine culture results. RESULTS: The screening of bacteriuria by Gram stains, urinalyses and microscopic examinations revealed the high sensitivity (91.9%) and negative predictive value(95.5%) with cost saving of 41.8% of inoculating media. Not considering the Gram stains, the screening revealed 83.8% sensitivity and 92.5% negative predictive value, even if the cost saving of inoculating media were as high as 50.1%. CONCLUSION: It was demonstrated that it was sensitive and economic and produced rapid preliminary results to screen bacteriuria by the Gram stains combined with urinalyses and microscopic examinations.