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

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.

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S44
Author(s):  
R. Stenstrom ◽  
J. Choi ◽  
E. Grafstein ◽  
T. Kawano ◽  
D. Sweet ◽  
...  

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.


2018 ◽  
Vol 63 (1) ◽  
Author(s):  
Allison M. Porter ◽  
Christopher M. Bland ◽  
Henry N. Young ◽  
David R. Allen ◽  
Sabrina R. Croft ◽  
...  

ABSTRACT Multiplex PCR combined with a pharmacist-driven reporting protocol was compared to the standard of care within a community hospital to evaluate initial changes after notification of a positive blood culture. The intervention group demonstrated decreased times to changes in antimicrobial therapy (P = 0.0081), increased changes to optimal antimicrobial therapy (P = 0.013), and decreased vancomycin use for coagulase-negative staphylococcus contaminants (P < 0.01) with multiplex PCR implementation and pharmacist intervention.


2017 ◽  
Vol 22 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Christina Ryan

Abstract Introduction: Blood cultures are critical values for identifying the source of an infection in patients seeking medical treatment for an acute illness. False-positive cultures can negatively influence patient care when physicians use inaccurate information to prescribe treatment. Inaccurate prescribed treatment negatively influences the quality of patient care related to prolonged medical treatment and hospital stay and unnecessary repetition of diagnostic tests. Purpose: The purpose of this project was to determine if blood culture contamination rates would be decreased if improved availability of CHG products was provided in all emergency department patient care areas would reduce the contamination rates of blood cultures. Methodology: The Theory of Planned Behavior provided the theoretical framework for this descriptive correlational project to examine barriers to following the procedural guidelines to cleanse venipuncture sites with a chlorhexidine gluconate (CHG) product before venipuncture Alcohol preparation pads were removed from the emergency department and a CHG product packaged similar to the alcohol preparation pads was placed in the department procedure trays and bedside carts. Results: During the first 2 weeks of the pilot project, blood culture contamination rates were reduced from 4.5% to 1.5%. The following month, rates remained low at 1.9%. Conclusion: Placement of CHG products at the bedside will improve patient safety and quality of care by reducing the incidence of inaccurate diagnosis and treatment based on false-positive blood cultures.


2016 ◽  
Vol 26 (5) ◽  
pp. 69-73
Author(s):  
Lina Savickaitė ◽  
Jelena Kopeykinienė

Rapid identification of the infecting organism may aid in choosing appropriate antimicrobial therapy. We used MALDI-TOF mass spectrometry to identify bacteria directly from the positive blood culture samples (n=21). 85,71 percent of these results was identified using of MALDI-TOF mass spectrometry. Identification time of bacteria directly from the blood culture takes more than 1 hour for 27,8 percent results.


2021 ◽  
Author(s):  
Ayami Shigeno ◽  
Yosuke Homma ◽  
Taiga Matsumoto ◽  
Shun Tanaka ◽  
Ryuta Onodera ◽  
...  

Abstract Background Blood culture is critical in treating infectious diseases, but contamination occurs in 0.6–12.5% of all samples. This leads to unnecessary intervention, inappropriate antibiotic use, and excess cost. Few studies have tackled patient factors, such as nursing care level, that could possibly affect contamination rates. Thus, this study aimed to explore the association between patients’ nursing care levels and blood culture contamination. Methods This is a single centered, retrospective, case-control study of adult patients whose blood culture specimens were taken in the emergency department between April 2018 and July 2019. The study was conducted in a 344-bed, urban, acute care community hospital in Chiba prefecture, Japan. We included patients aged 20 years and above, with two or more sets of blood cultures. The case group included patients with false positive blood culture results with contamination; the control group included patients with true positive or true negative blood culture results without contamination. We randomly selected two control patients per case. Patients’ age, sex, nursing care level, ambulance usage, housing status, Glasgow Coma Scale, and hospital arrival time were obtained from the patients’ medical charts. Results Of the 5,130 patients, 686 patients got positive blood culture results. Of the 686 patients, 35 patients were included in the case group, and 70 were randomly selected from the non-contaminated group and included in the control. In multivariate analysis, patients with contaminated blood cultures had a higher nursing care level (odds ratio: 5.24; 95% confidence interval: 1.47 to 18.70; P = 0.02). Conclusions A higher nursing care level is associated with a higher incidence of blood culture contamination in the emergency department. Careful and appropriate procedures are required for patients with a higher nursing care level.


2019 ◽  
Vol 144 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Sadia Syed ◽  
David T. Liss ◽  
Chris O. Costas ◽  
Janis M. Atkinson

Context.— Blood culture contamination is a common problem faced by medical centers and leads to significant cost. A possible method to reduce contamination is to discard the initial aliquot of blood, which contains skin and bacteria. Objective.— To determine whether the rate of contaminant blood cultures could be reduced by changing the order of draw to divert the first 7 mL to a gold- or green-top tube. Design.— A preintervention and postintervention study was conducted. During the 18-month intervention phase (September 2015–February 2017), all nurses in the emergency department and inpatient floor phlebotomists collected blood cultures by drawing the first 7 mL of blood into a gold- or green-top tube followed by drawing blood for blood culture bottles. The 18 months immediately preceding the study period (February 2014–July 2015) were used for comparison. Results.— There was an overall statistically significant decrease in contamination rate from 2.46% in the prediversion protocol group to 1.70% in the postdiversion protocol group (P &lt; .001). Emergency department drawn cultures and inpatient cultures showed significant decrease in contamination rates between the preprotocol and postprotocol groups, 2.92% versus 1.95% (P &lt; .001) for emergency department, and 1.82% versus 1.31% (P = .03) for inpatient. We noted less month-to-month variation during the study period compared with the preintervention period. Conclusions.— By using this simple diversion method, we were able to improve blood culture contamination rates for our emergency department and inpatients while incurring no added cost to the procedure.


2009 ◽  
Vol 10 (1_suppl) ◽  
pp. S24-S26 ◽  
Author(s):  
Frankie Thompson ◽  
Maurice Madeo

The culture of micro-organisms from blood is an essential laboratory test for the diagnosis of bacteraemia. Early positive results provide valuable diagnostic information on which appropriate antimicrobial therapy can be initiated. Like any tests, however, false-positive blood culture results can limit the utility of this important tool. These false-positive results arise due to contamination. Reports from NHS trusts and equipment suppliers suggest these contamination rates could be as high as 10% (Department of Health (DH), 2007). A variety of strategies have been investigated and employed to decrease contamination rates. This article describes the utility of a variety of approaches to reduce the number of false-positive percutaneous blood cultures specifically in the adult population.


Sign in / Sign up

Export Citation Format

Share Document