scholarly journals Financial and Clinical Impact of False‐Positive Blood Culture Results

2001 ◽  
Vol 33 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Mark L. Waltzman ◽  
Marvin Harper
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
False Positive ◽  
Clinical Impact

scholarly journals 2559. Incidence and Clinical Impact of Discordant Genotypic and Phenotypic Categorization of Methicillin Susceptibility in Staphylococcus aureus Bacteremia

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S70-S70
Author(s):  
Jessica Gulliver ◽  
Brittney Jung-Hynes ◽  
Derrick Chen
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Rapid Identification ◽  
Clinical Impact ◽  
Staphylococcus Aureus Bacteremia ◽  
Oxacillin Resistance ◽  
Initial Hospitalization

Abstract Background Methicillin-susceptible/methicillin-resistant Staphylococcus aureus (MSSA/MRSA) can be directly identified from positive blood culture bottles using molecular methods. This provides faster results than traditional phenotypic testing, but discrepancies between the two are occasionally found. We sought to determine the incidence and clinical impact of such discrepancies. Methods Positive blood culture bottles are routinely tested in the hospital clinical laboratory for mecA via Xpert MRSA/SA BC (PCR), and antimicrobial susceptibility testing (AST) via MicroScan PC33 is performed on recovered S. aureus isolates; discrepancies between PCR and AST are resolved by repeat and supplemental (Kirby-Bauer) testing. A retrospective review of medical and laboratory data from January 2015 to December 2017 was performed on all patients that had discordant PCR and AST results. Results Approximately 1,200 PCR assays were performed from January 2015 to December 2017, and there were 5 (0.4%) cases with discordant AST Results. Four cases were classified as MSSA by PCR but MRSA by AST, and 1 case was classified as MRSA by PCR but MSSA by AST. For the former group, antimicrobial therapy was changed in 2 patients to cover MRSA and 1 patient was readmitted, while the remaining 2 patients were already being treated for MRSA; for the latter case, this patient was treated for MRSA during the initial hospitalization, but was readmitted with disseminated MSSA and subsequently deceased. Based on genetic targets identified by PCR and cefoxitin and oxacillin AST, discrepancies were likely due to borderline oxacillin resistance (BORSA) (n = 1), presence of an SCCmec variant not detected by PCR (n = 1), or undetermined (n = 3). Conclusion Rapid identification of MRSA bacteremia via PCR provides actionable information to direct empiric treatment. While highly accurate, PCR results are infrequently not corroborated by AST. This rare possibility should be considered when modifying therapy based on initial PCR results, and there should be close communication between the clinical team and laboratory for these challenging cases. Disclosures All authors: No reported disclosures.

False-positive blood culture results in patients with hematologic malignancies

2019 ◽  
Vol 25 (5) ◽  
pp. 404-406
Author(s):  
Yasuhiro Ebihara ◽  
Kiyoko Kobayashi ◽  
Noriyuki Watanabe ◽  
Yoshitada Taji ◽  
Tomoya Maeda ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
False Positive ◽  
Hematologic Malignancies

Increased peripheral leukemia blasts leading to false-positive blood culture

2017 ◽  
Vol 64 ◽  
pp. 8-9 ◽  
Author(s):  
Maliha Khan ◽  
Rabbia Siddiqi ◽  
Marina Konopleva ◽  
Micah M. Bhatti ◽  
Christopher B. Benton
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
False Positive

scholarly journals Blood Culture Contamination in a Community Hospital- less than 2% is achievable

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S127-S127
Author(s):  
R Bedi ◽  
J Atkinson
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
False Positive ◽  
Community Hospital ◽  
Blood Cultures ◽  
Proper Order ◽  
Multiple Devices ◽  
American Society

Abstract Introduction/Objective Blood cultures are commonly obtained to evaluate the presence of bacteria or fungal infection in a patient’s bloodstream. The presence of living microorganisms circulating in the bloodstream is of substantial prognostic and diagnostic importance. A positive blood culture indicates a reason for the patient’s illness and provides the etiological agent for antimicrobial therapy. Collection of blood culture is an exact process that requires time, the proper order of draw, and following of correct protocol. The busy Emergency department that requires multiple demands for nurse’s time, turnover of staff, rushing from one task to another can result in the improper collection and false-positive blood cultures. The national benchmark is set at 3% by the American Society of Clinical Microbiology (ASM) and The Clinical and Laboratory Standard Institute (CLSI). False-positive blood culture results in increased length of stay and unnecessary antimicrobial therapy, resulting in an increased cost burden to the hospital of about $5000 per patient. Methods/Case Report At our 150-bed community hospital, 26 beds Emergency Department, we have come a long way in reduction of our blood culture contamination rates from upwards of 4% to less than 2%, far lower than the national benchmark. Results (if a Case Study enter NA) NA Conclusion There are multiple devices available from various manufacturers claiming to reduce blood culture contamination. These devices do reduce blood culture (BC) contamination but at an added cost of the device. The rate of BC can be reduced and less than 3% is achievable by materials available in the laboratory. We have achieved this by providing training to every new staff by demonstration and direct observation, providing everything required for collection in a kit, using proper technique, the inclusion of diversion method that involves the aseptic collection of a clear tube before collecting blood cultures, and following up monthly on any false positive blood cultures.

scholarly journals LO47: Use of C-reactive protein can safely decrease the number of emergency department patients with sepsis who require blood cultures

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S44
Author(s):  
R. Stenstrom ◽  
J. Choi ◽  
E. Grafstein ◽  
T. Kawano ◽  
D. Sweet ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
False Positive ◽  
Blood Cultures ◽  
Low Risk ◽  
Reactive Protein ◽  
Emergency Department Patients ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

Introduction: Sepsis protocols call for the acquisition of blood cultures in septic emergency department (ED) patients.However, the criteria for blood cultures are vague, they are costly, only positive 8-12% of the time, with up to half of these being false positives. The objective of this study was to establish if positive blood cultures could be excluded in low-risk sepsis patients with levels of CRP below 20 ml/L. Methods: This was a multicenter prospective cohort study of 765 ED patients at St Paul’s and Mount St Joseph’s hospitals in Vancouver with sepsis (2 or more SIRS criteria and infection) and none of: immuncompromised, injection drug use, indwelling vascular device or septic shock (SBP<90 mmhg). Consecutive patients with sepsis had CRP and blood cultures obtained at the same time.OUTCOMES. True positive blood cultures, false positive blood cultures, positive blood cultures that changed patient management. True and false positive blood cultures were based on Infectious Disease Society of America Guidelines, and change in management was defined as change in type or length of antibiotic therapy and was blindly adjudicated by a medical microbiologist. Results: 765 ED patients with sepsis met inclusion criteria. Mean age was 48.3 years and 57% were male. Blood cultures were positive in 99/765 (12.9%) subjects, of which 19 were false positive (19.2%). CRP was >20 mg/L in 595/765 (77.8%) of patients. Of 170 subjects with a CRP<20 mg/L, 3 had a positive blood culture (1.8%; 95% CI 0.1%- 5%). Management was not changed in any patient with a positive blood culture and CRP level<20 mg/L. Of 19 subjects with a false positive blood culture, CRP was <20 mg/L for 6 (31.6%). Conclusion: In this cohort of low-risk sepsis patients, based on a CRP of <20 mg/L, acquisition of blood cultures could be safely avoided in 22.2% of patients, at significant savings to the health care system.

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