日本新生児成育医学会雑誌　37(2)：77-82；2025　

日本新生児成育医学会雑誌　第37巻　第2号　77 ～ 82頁（2025年）

受付日：2024．12．09

受理日：2025．03．07

NICU 入院患者における血液培養複数回採取の推奨とその効果

Recommendation and Effectiveness of Multiple Blood Cultures in Patients Admitted to Neonatal Intensive Care Unit

＊ 1 国立病院機構小倉医療センター　小児科，＊ 2 九州大学病院　小児科

＊ 1 Department of Pediatrics, National Hospital Organization Kokura Medical Center， ＊ 2 Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University

野中裕文＊ 1 ＊ 2・山喜多悠一＊ 1・川上　勳＊ 1・楢崎健太郎＊ 1・ 湯浅千春＊ 1・田中幸一＊ 1・倉田浩昭＊ 1・中嶋敏紀＊ 1

Hirofumi NONAKA ＊ 1 ＊ 2，Yuichi YAMAKITA ＊ 1，Isao KAWAKAMI ＊ 1，Kentaro NARAZAKI ＊ 1，Chiharu YUASA ＊ 1，Kouichi TANAKA ＊ 1，Hiroaki KURATA ＊ 1，Toshinori NAKASHIMA ＊ 1

Key Words：neonatal intensive care unit，multiple blood cultures，bacteremia，positive rates

新生児における血液培養複数回採取は有効性に一定の見解が得られておらず，採取困難もあり実施率は低い。当 院NICU で複数回採取を推奨した効果を検討した。対象は2016 年4 月～ 2024 年3 月に提出した血液培養検体。1 回採取につき小児用好気ボトル1 本を使用し，1 エピソードで提出された血液培養は1 回，2 回採取ともに1 件とカ ウントした。2019 年10 月より複数回採取を推奨し2 回採取率は推奨前1.2％（10/812），推奨後73.1％（582/796） と増加した。観察期間中の汚染を除く採取回数別陽性率は1 回採取1.4％（14/1,016），2 回採取3.4％（20/592）で 有意差あり（p＝0.01），汚染率に差はなかった。汚染を除き，2 回採取し1 回採取分のみ陽性は5 件認めた。複数 回採取は汚染の判断に有用なことに加え，NICU 入院患者においても陽性率を向上させ，菌血症例の診断と治療に 有益と考えられた。

The effectiveness of multiple blood cultures in neonates has not been determined, and the multiple culture rate is low, partly because of the difficulty of the sampling technique. We analyzed the effectiveness of multiple blood cultures in our neonatal intensive care unit. Blood culture bottles were collected between April 2016 and March 2024. Pediatric aerobic culture bottles were used, and both single and double samplings were counted as one case. Before the recommendation for multiple blood cultures was issued in October 2019, the two-sampling rate was 1.2％（ 10/812）. After the recommendation, the rate increased to 73.1％ （582/796）. During the observation period, a significant difference （p＝0.01） was observed in the positive rate excluding contamination, which was 1.4％（ 14/1,016） for one blood culture and 3.4％（ 20/592） for two blood cultures. No difference was observed in the contamination rate. Excluding contamination, 5 positive cases with two blood cultures were observed from only one blood culture bottle. In addition to being useful in determining contamination, multiple blood cultures were considered beneficial in diagnosing and treating bacteremia by increasing the positive rate among patients who were admitted to the neonatal intensive care unit.