Analysis of red blood cell alloimmunization among inpatients: 104 588 cases / 中国输血杂志

【Objective】 To analyze the yield, specificity and detection time of red blood cell(RBC)alloimmunization in 104 588 inpatients. 【Methods】 The clinical information of patients who underwent at least one antibody screening in our hospital from November 2017 to December 2019 was retrospectively analyzed. The demographic characteristics, transfusion history, pregnancy history and antibody screening results of patients were collected. The RBC alloantibody yield, specificity and detection time were analyzed, and differences of transfusion units and frequency between patients with and without alloimmunization were compared. 【Results】 Eight hundred cases of alloantibodies with clinical significance were detected in blood samples of 723 patients, with a positive rate of 0.7% (723/104 588). The incidence rate of alloimmunization in females was higher than that in males (0.9% vs 0.5%, P<0.05). Rh alloantibodies accounted for 76.4%(611/800), of which 61.4%(375/611)were anti-E. Transfusion units and frequency of patients with alloimmunity were higher than those without(median: 6.0 vs 4.0, P<0.05; 4.0 vs 2.0, P<0.05, respectively). And 67.5% of RBC alloantibodies were detected within 6 months, with the median (IQR) detection time of 97.0 (22.5-247.0) days. 【Conclusion】 Routine antibody screening should be performed before transfusion in order to reduce the occurrence of adverse reactions, and Rh typing transfusion with compatible crossmatch should be performed if necessary.

An emergence of Mycobacterium abscessus in blood cultures of Thai patients

@#Aims: Tuberculosis and other mycobacterial infections occur worldwide especially in patients with immunodeficiency. Typically, an empirical treatment for disseminated disease is required for initial therapy due to slow growing nature of most mycobacterial species. Therefore, species distribution and average time to positivity of blood culture is crucial. However, such information is limited for blood culture and, therefore, were determined. Methodology and results: The blood culture data using the BACTEC FX system and drugs susceptibility testing (DST) pattern was recovered during 2012-2017 from a large teaching hospital in Bangkok, Thailand. Overall, 7.8% of 4,838 blood and 6.4% of 1,056 bone marrow (BM) samples were positive for mycobacterial growth. Mycobacterium tuberculosis complex (MTBC), M. avium, and M. abscessus, were the most three common species to be isolated from blood (3.8%, 2.1%, and 0.9%, respectively) and BM (2.4%, 2.4%, and 0.9%, respectively). The average time to positivity for MTBC, M. avium, and M. abscessus was 25.7, 16.1, and 3.8 days, respectively. From 209 antimycobacterial susceptibility testing (AST)-available MTBC strains, 6 (2.87%) strains were multi-drugs resistant (MDR-TB). From 35 AST-available M. avium complex (MAC) isolates, 6 (17.14%), 33 (94.29%), and 28 (80%) isolates were resistant to clarithromycin, moxifloxacin, and linezolid, respectively. BM MAC isolates were significantly more resistant to clarithromycin than the blood isolates (44.5% vs 7.69%; p= 0.027). Conclusion, significance and impact of study: In summary, an emergence of M. abscessus and unusually high moxifloxacin and linezolid resistance of MAC isolates were reported in this study. Additional information of this study benefits physicians for anti-mycobacterial drug selection for initial treatment of mycobacteremia while blood and BM culture is pending.

Effect of Preincubation of Blood Culture Bottles in a BacT/Alert Unit Outside Laboratory Operating Hours on Detection Time / 대한임상미생물학회지

BACKGROUND: The pre-storage condition of blood culture bottles prior to entering the automated blood culture system may affect the time to detection (TTD) of microorganisms and the final report days. METHODS: We compared the TTD and final report days according to the pre-incubation conditions after laboratory operating hours: room temperature (RT) vs. a BacT/Alert unit (BioMerieux Inc.) for 3 months respectively. All bottles were inserted into the main BacT/Alert system the next morning. RESULTS: TTD was significantly reduced by pre-incubating bottles in a BacT/Alert unit (median, 8.4 h) compared to pre-storage at RT (median, 12.4 h) (P< 0.001). The final report of bacterial identification and drug susceptibility within 2 days was available for 24.4% of bottles pre-incubated in a BacT/Alert unit compared to 14.9% of those incubated at RT. The false positive results were significantly higher for pre-incubation in a BacT/Alert unit (0.81%) than for that (0.29%) at RT (P<0.001). CONCLUSION: If a clinical microbiology laboratory is not operational for 24 hours, an automated blood culture unit might be a good alternative to reduce TTD and allow the submission of a faster final report compared to pre-storage at RT. However, false positive readings increased more than two-fold by pre-incubation in a BacT/Alert unit.

Evaluation of Risk Priority of the Dispensing Process by Using a Risk Management System in Community Pharmacies / 医薬品情報学

<b>Objective: </b>It is important to prevent dispensing errors for the safety of patients.  For this purpose, it is necessary to improve the dispensing process on the basis of risk priority.  Quantitative evaluation of risk in each operation makes it possible to compare the risk relatively.  In this study, we analyzed data reported in the Pharmacy Risk Error Management System (PREM-S) to evaluate the risk priority in the medicine preparation step of the dispensing process.<br><b>Methods: </b>Data of 1,202 cases concerning medicine preparation step were extracted from in 2,458 cases reported into PREM-S between May 2010 and April 2011.  We classified the medicine preparation step into 31 categories based on the operation.  We analyzed the levels in each category as adverse effects on patient’s health by the errors and also the relationship between adverse effect and detection time.  The level represents the degree of adverse effect for the patient.<br><b>Results: </b>Information on levels of the 31 categories was obtained from the analysis.  Eight categories included reports of effects on the health of patients.  Three categories such as calculation of powder medicine included level 4 cases.  Detection time was significantly different between level 1 and levels 2 to 4, but there was no significant difference between levels 2 to 4.<br><b>Conclusion: </b>The results suggest that analysis of data reported in PREM-S enables evaluation of the risk priority systematically and efficiently.  Evaluation of the risk priority will contribute to prevention of dispensing errors and health effects derived from them.

BACTEC PLUS Blood Culture Media vs BacT/Alert FA Blood Culture Media in Detecting Bacterial Pathogens in Samples Containing Antibiotics / 中华医院感染学杂志

0.05).BD-P bottles need less detection time in bottles containing ciprofloxacin,?-lactam antibiotics and vancomycin(P