scholarly journals 660. Effect of the COVID-19 Pandemic on Blood Culture Contamination Rates and Quality Improvement Processes

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S432-S432
Author(s):  
Alexander G Hosse
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Nursing Staff ◽  
Blood Cultures ◽  
Hospital Length Of Stay ◽  
Contamination Rate ◽  
Culture Collections ◽  
Total Blood ◽  
Primary Driver ◽  
Inpatient Units

Abstract Background Blood cultures are the gold standard for diagnosing bloodstream infections and a vital part of the work-up in systemic infections. However, contamination of blood cultures represents a significant burden on patients and the healthcare system with increased hospital length of stay, unnecessary antibiotics, and financial cost. The data discussed here offer insight into blood culture contamination rates before and through the COVID-19 pandemic at a community hospital and the processes that were affected by the pandemic. Methods Blood culture contaminations were determined by using the number of sets of blood cultures with growth and the presence of an organism from the National Healthcare Safety Network's (NHSN) commensal organism. Contamination rates were evaluated by status as a standard unit or a COVID-19 isolation unit in either the emergency department (ED) or inpatient floor units. The identified four groups had different processes for drawing blood cultures, particularly in terms of training of staff in use of diversion devices. The electronic medical record was used to track contaminations and the use of diversion devices in the different units. Results The inpatient COVID units were consistently elevated above the other units and the institutional contaminant goal of 2.25%, ranging from 9.6% to 13.3% from 4/2020-9/2020. Those units were the primary driver of the increase in overall contamination rates. COVID ED nursing staff (that had previously undergone training in the use of diversion devices) used diversion devices to draw 51 of 133 (38.3%) cultures compared to only 15 of 84 (17.9%) on the COVID inpatient units. Figure 1. Comparison of contamination rates in the ED vs the inpatient units from all campuses from September 2019 through September 2020. The blue line represents the hospital goal of 2.25% contamination rate. Solid lines represent total contamination rates including COVID isolation units whereas dotted lines represent units excluding COVID isolation units. Figure 2. Comparison of the non-COVID vs COVID isolation units in the emergency department and inpatient units. The red line represents the hospital goal of less than 2.25% for blood culture contamination rate. Table of Contaminants vs. Total Collected Blood Cultures in Each Unit by Month Figure 3. Raw data from Figure 2. Total blood culture contaminations from each unit by month compared to total blood culture collections from each unit by month. Conclusion Evaluation revealed that nursing staff with less training in blood culture collection, particularly the use of diversion devices, were the primary staff collecting blood cultures in the inpatient COVID units. The difference in training is felt to be the primary driver of the increase in contaminants in the inpatient COVID units. The marked increase in contaminations highlights the difficulties of maintaining quality control processes during an evolving pandemic and the importance of ongoing efforts to improve the quality of care. These findings demonstrate the importance of training and routine use of procedures to reduce contaminations even during. Disclosures All Authors: No reported disclosures

scholarly journals Evaluation of an Initial Specimen Diversion Device (ISDD) on Rates of Blood Culture Contamination in the Emergency Department

2021 ◽  
Vol 14 ◽  
pp. 73-76
Author(s):  
Blake Buzard ◽  
Patrick Evans ◽  
Todd Schroeder
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Blood Culture ◽  
Blood Cultures ◽  
Contamination Rate ◽  
Total Hospital Cost ◽  
Initial Specimen ◽  
Significant Difference ◽  
Secondary Outcomes ◽  
The Impact

Introduction: Blood cultures are the gold standard for identifying bloodstream infections. The Clinical and Laboratory Standards Institute recommends a blood culture contamination rate of <3%. Contamination can lead to misdiagnosis, increased length of stay and hospital costs, unnecessary testing and antibiotic use. These reasons led to the development of initial specimen diversion devices (ISDD). The purpose of this study is to evaluate the impact of an initial specimen diversion device on rates of blood culture contamination in the emergency department.  Methods: This was a retrospective, multi-site study including patients who had blood cultures drawn in an emergency department. February 2018 to April 2018, when an ISDD was not utilized, was compared with June 2019 to August 2019, a period where an ISDD was being used. The primary outcome was total blood culture contamination. Secondary outcomes were total hospital cost, hospital and intensive care unit length of stay, vancomycin days of use, vancomycin serum concentrations obtained, and repeat blood cultures obtained.  Results: A statistically significant difference was found in blood culture contamination rates in the Pre-ISDD group vs the ISDD group (7.47% vs 2.59%, p<0.001). None of the secondary endpoints showed a statistically significant difference. Conclusions: Implementation of an ISDD reduces blood culture contamination in a statistically significant manner. However, we were unable to capture any statistically significant differences in the secondary outcomes.

scholarly journals Reducing Blood Culture Contamination; a Quality Improvement Project in Emergency Department

2020 ◽  
Vol 41 (S1) ◽  
pp. s368-s369
Author(s):  
Itisha Gupta ◽  
Jane Codd
Keyword(s):  
Blood Culture ◽  
Positive Culture ◽  
Blood Cultures ◽  
Patient Treatment ◽  
Contamination Rate ◽  
Negative Consequences ◽  
Total Blood ◽  
Improvement Project ◽  
Competency Training ◽  
The Impact

Background: Blood culture is an important investigation in diagnosing sepsis. Positive culture helps to tailor therapy and is crucial in antimicrobial stewardship (AMS). However, positive blood culture does not always denote a bloodstream infection. Sometimes, false-positive results occur because of contamination from organisms outside the bloodstream, leading to significant negative consequences to patient treatment decisions and financial implications. Rates of blood culture contamination vary widely (0.6%–6%) between organizations, and although it is very difficult to eliminate contamination, it can be minimized. Our hospital group has multiple sites including emergency departments (EDs). We have been intermittently monitoring blood culture contamination rates since 2008, which decreased from 6.8% to 4.8% in 2009 but remained static when audited in 2010, 2012, and 2015. Objectives: To reduce our blood culture contamination rate further by targeting 2 busy EDs and by introducing continuous surveillance of blood culture contamination across 3 hospitals beginning in April 2016. Methods: In 2015, for the first time, blood culture contamination rates for both EDs, based in 2 different hospitals, were calculated. The ED results were communicated to the healthcare workers (HCWs), who agreed to establish a continuous surveillance of blood culture contamination and to participate in a reduction plan. Competency training was conducted according to training needs analysis. For example, phlebotomists were trained to ensure the use of the appropriate blood culture kit and educational sessions were tailored to staff groups. The blood culture contamination rate was monitored from April 2016 to March 2019 for 3 hospitals and both EDs to determine the impact of various measures introduced during this time. Results: In 2015, contamination rate of the 3 hospitals was 4.07%, and 10.2% of total blood cultures flagged positive. Also, 25% of blood cultures were requested from Eds, but these samples comprised 54% of the total contamination. The contamination rates for EDs A and B were 7.4% and 10.6%, respectively, which were significantly higher than the overall rate. From April 16 to March 19, there was 22% increase in total blood cultures performed. Results were analyzed quarterly. In total, 8,525 blood culture sets were received in January–March 2019; of these, the EDs contributed 2,799 sets (32.8%). The total blood culture contamination rate in January–March 2019 decreased to 3.1%. Both EDs A and B showed decreases in their contamination rates to 5.5% and 7.4%, respectively, in 2018–2019. The quarterly decreases were 5.2% and 4.9% in January–March 2019. Conclusions: The emphasis on the sepsis pathway probably led to year-on-year increases in total blood culture sets. Both ED blood culture contamination rates decreased. Consistent efforts in education, training, ensuring competency to various HCW groups, and provision of adequate blood culture kits are important for sustaining these improvements.Funding: NoneDisclosures: None

scholarly journals Regression Discontinuity of Blood Culture Contamination Rate After Changing of Disinfectants: Retrospective Observational Study

2021 ◽  
Author(s):  
Koshi Ota ◽  
Daisuke Nishioka ◽  
Yuri Ito ◽  
Emi Hamada ◽  
Naomi Mori ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Observational Study ◽  
Regression Discontinuity ◽  
Blood Cultures ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Contamination Rate ◽  
Blood Collection ◽  
Contaminated Blood

Abstract Background: Blood cultures are indispensable for detecting life-threatening bacteremia. Little is known about associations between contamination rates and topical disinfectants for blood collection in adults.Objective: We sought to determine whether a change in topical disinfectants was associated with the rates of contaminated blood cultures in the emergency department of a single institution.Methods: This single-center, retrospective observational study of consecutive patients aged 20 years or older was conducted in the emergency department (ED) of a university hospital in Japan between August 1, 2018 and September 30, 2020. Pairs of blood samples were collected for aerobic and anaerobic culture from the patients in the ED. Physicians selected topical disinfectants according to their personal preference before September 1, 2019; alcohol/chlorhexidine gluconate (ACHX) was mandatory thereafter, unless the patient was allergic to alcohol. Regression discontinuity analysis was used to detect the effect of the mandatory usage of ACHX on rates of contaminated blood cultures.Results: We collected 2,141 blood culture samples from 1097 patients and found 164 (7.7%) potentially contaminated blood cultures. Among these, 445 (20.8%) were true bacteremia and 1,532 (71.6%) were true negatives. Puncture site disinfection was performed with ACHX for 1,345 (62.8%) cases and with povidone-iodine (PVI) for 767 (35.8%) cases. The regression discontinuity analysis showed that mandatory ACHX usage significantly reduced the blood culture contamination rate by 9.6% (95% confidence interval (CI): 5.0%–14.2%, P <0.001).Conclusion: Rates of contaminated blood cultures were significantly lower when ACHX was used as the topical disinfectant.

scholarly journals Estimated Clinical and Economic Impact through Use of a Novel Blood Collection Device To Reduce Blood Culture Contamination in the Emergency Department: a Cost-Benefit Analysis

2018 ◽  
Vol 57 (1) ◽  
Author(s):  
Erik Skoglund ◽  
Casey J. Dempsey ◽  
Hua Chen ◽  
Kevin W. Garey
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Economic Impact ◽  
Hospital Costs ◽  
Cost Savings ◽  
Cost Benefit ◽  
Culture Collection ◽  
Blood Cultures ◽  
Hospital Length Of Stay ◽  
Decision Analysis Model

ABSTRACTBlood culture contamination results in increased hospital costs and exposure to antimicrobials. We evaluated the potential clinical and economic benefits of an initial specimen diversion device (ISDD) when routinely utilized for blood culture collection in the emergency department (ED) of a quaternary care medical center. A decision analysis model was created to identify the cost benefit of the use of the ISDD device in the ED. Probabilistic costs were determined from the published literature and the direct observation of pharmacy/microbiology staff. The primary outcome was the expected per-patient cost savings (microbiology, pharmacy, and indirect hospital costs) with the routine use of an ISDD from a hospital perspective. The indirect costs included those related to an increased hospital length of stay, additional procedures, adverse drug reactions, and hospital-acquired infections. Models were created to represent hospitals that routinely or do not routinely use rapid diagnostic tests (RDT) on positive blood cultures. The routine implementation of ISDD for blood culture collection in the ED was cost beneficial compared to conventional blood culture collection methods. When implemented in a hospital utilizing RDT with a baseline contamination rate of 6%, ISDD use was associated with a cost savings of $272 (3%) per blood culture in terms of overall hospital costs and $28 (5.4%) in direct-only costs. The main drivers of cost were baseline contamination rates and the duration of antibiotics given to patients with negative blood cultures. These findings support the routine use of ISDD during blood culture collection in the ED as a cost-beneficial strategy to reduce the clinical and economic impact of blood culture contamination in terms of microbiology, pharmacy, and wider indirect hospital impacts.

scholarly journals Diversion Principle Reduces Skin Flora Contamination Rates in a Community Hospital

2019 ◽  
Vol 144 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Sadia Syed ◽  
David T. Liss ◽  
Chris O. Costas ◽  
Janis M. Atkinson
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Community Hospital ◽  
Blood Cultures ◽  
Contamination Rate ◽  
Significant Cost ◽  
Intervention Phase ◽  
Medical Centers ◽  
Protocol Group ◽  
Skin Flora

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.

scholarly journals Regression discontinuity of blood culture contamination rate after changing of disinfectants: retrospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Koshi Ota ◽  
Daisuke Nishioka ◽  
Yuri Ito ◽  
Emi Hamada ◽  
Naomi Mori ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Observational Study ◽  
Regression Discontinuity ◽  
Blood Cultures ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Contamination Rate ◽  
Blood Collection ◽  
Contaminated Blood

AbstractBlood cultures are indispensable for detecting life-threatening bacteremia. Little is known about associations between contamination rates and topical disinfectants for blood collection in adults. We sought to determine whether a change in topical disinfectants was associated with the rates of contaminated blood cultures in the emergency department of a single institution. This single-center, retrospective observational study of consecutive patients aged 20 years or older was conducted in the emergency department (ED) of a university hospital in Japan between August 1, 2018 and September 30, 2020. Pairs of blood samples were collected for aerobic and anaerobic culture from the patients in the ED. Physicians selected topical disinfectants according to their personal preference before September 1, 2019; alcohol/chlorhexidine gluconate (ACHX) was mandatory thereafter, unless the patient was allergic to alcohol. Regression discontinuity analysis was used to detect the effect of the mandatory usage of ACHX on rates of contaminated blood cultures. We collected 2141 blood culture samples from 1097 patients and found 164 (7.7%) potentially contaminated blood cultures. Among these, 445 (20.8%) were true bacteremia and 1532 (71.6%) were true negatives. Puncture site disinfection was performed with ACHX for 1345 (62.8%) cases and with povidone-iodine (PVI) for 767 (35.8%) cases. The regression discontinuity analysis showed that mandatory ACHX usage was significantly associated with lower rates of contaminated blood cultures by 9.6% (95% confidence interval (CI): 5.0%–14.2%, P < 0.001). Rates of contaminated blood cultures were significantly lower when ACHX was used as the topical disinfectant.

scholarly journals Decreasing Blood Culture Contamination Rates Using A Specimen Diversion Device: A Quasi-Experimental Study

2020 ◽  
Vol 41 (S1) ◽  
pp. s468-s468
Author(s):  
Ahmed Babiker ◽  
Aditi Ramakrishnan ◽  
Jessica Howard-Anderson ◽  
Jill Holdsworh ◽  
Mini Jacob ◽  
...  
Keyword(s):  
Experimental Study ◽  
Blood Culture ◽  
Blood Cultures ◽  
Contamination Rate ◽  
Relative Reduction ◽  
Coagulase Negative Staphylococci ◽  
Total Blood ◽  
Level Change ◽  
Its Analysis ◽  
Quasi Experimental

Background: Blood culture contamination rates are frequently higher than the ≤3% standard in the emergency department (ED). Objective: We sought to determine whether the implementation of a blood diversion device that mechanically sequesters the initial aliquot of the blood culture sample decreased blood culture contamination rates. Methods: We performed a quasi-experimental study in two 500-bed hospitals. The blood-diversion device was implemented in the ED in hospital A, but not in hospital B, starting in January 2018. Preintervention data were collected over a 29-month baseline period, and postintervention data were collected for 20 months. Both hospitals provided ongoing feedback on contamination rates. Blood culture contamination was defined as presence of common skin microbiota (eg, coagulase-negative staphylococci) in only 1 of ≥2 blood culture sets collected within 24 hours. Preintervention and postintervention blood culture contamination rates were calculated based on total blood cultures collected and were compared within and between hospitals using the Wilcoxon rank-sum test. Changes in preintervention and postintervention total and ED contamination rates within hospitals were calculated as rate ratios (RRs) using interrupted time series (ITS) analysis with segmented Poisson regression. Results: Among 212,789 total blood cultures (hospital A, 70,005; hospital B, 142,784), 4,025 (1.8%) were contaminated. In hospital A, the intervention resulted in a decrease in overall median blood culture contamination rates (2.4% vs 1.4%; P < .001) and ED median blood culture contamination rates (4.7% vs 2.6%; P < .001), whereas in hospital B there was no significant change during the same period in overall (2.3% vs 2.0%) or ED (5.0% vs 5.0%) median blood culture contamination rates. In the ITS analysis, the intervention was associated with an immediate decrease in hospital A’s contamination rate by 21.3% (level change RR, 0.79; 95% CI, 0.63–0.98; P = .04) overall and 21.0% (level change RR, 0.79; 95% CI, 0.62–1.0; P =.06) in the ED. After the intervention, there was a continued decrease in hospital A’s overall (trend change RR, 0.95; 95% CI, 0.93–0.97; P < .001) and ED (trend RR, 0.94; 95% CI, 0.92–0.96; P < .001) blood culture contamination rates, but not in hospital B’s overall (trend change RR, 1.02; 95% CI, 1.00–1.02; P = .01) or ED (RR, 1.00; 95% CI, 0.99–1.02; P = .30) blood culture contamination rates during the same period. Conclusions: Implementation of the blood diversion device in the ED resulted in a >20% relative reduction from a baseline of 5% of ED blood culture contamination rates. Continued improvement after implementation suggests ongoing efforts to address the workflow and the culture of safety are needed to optimize the use of this device.Funding: NoneDisclosures: None

scholarly journals 118. Eliminating Blood Culture Contamination with an Initial-specimen Diversion Device

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S187-S187
Author(s):  
Lucy S Tompkins ◽  
Alexandra Madison ◽  
Tammy Schaffner ◽  
Jenny Tran ◽  
Pablito Ang
Keyword(s):  
Health Care ◽  
Blood Culture ◽  
Nursing Staff ◽  
False Positive ◽  
Blood Cultures ◽  
Traditional Methods ◽  
Standard Methods ◽  
Candida Sp ◽  
Initial Specimen ◽  
Skin Flora

Abstract Background Blood samples obtained via traditional venipuncture can become contaminated by superficial and deeply embedded skin flora. We evaluated the hospital-wide use of an initial-specimen diversion device (ISDD) designed to shunt these microorganisms away from the culture bottle to reduce blood culture contamination (BCC) and sequelae: false-positive central line-associated bloodstream infections (CLABSIs), repeat blood culture draws, inappropriate antibiotic usage, increased patient length-of-stay and misdiagnosis. The study aimed to show the proportion of blood cultures containing contaminants drawn by phlebotomy staff using the ISDD versus those drawn using traditional methods. Nursing staff continued to use traditional methods to draw blood cultures in the emergency department (ED) and from inpatients. Methods Over a four-month trial at Stanford Health Care (SHC), 4,462 blood cultures were drawn by phlebotomy staff using the ISDD (Steripath Gen2, Magnolia Medical Technologies) in the ED and from inpatients; 922 blood cultures were obtained by phlebotomy staff using standard methods. Additionally, 1,413 blood cultures were drawn by nursing staff using standard methods. The number of matched sets (2 bottles [aerobic/anaerobic] plus 2 bottles [aerobic/anaerobic], with total volume 40 ml) obtained through traditional methods and by the ISDD were recorded. Contaminants were defined by the National Healthcare Safety Network (NHSN). In addition, sets in which 1 out of 4 bottles contained vancomycin-resistant Enterococcus (VRE) or Candida sp. were also recorded, even though these are not considered contaminants by the NHSN. Results Of 4,462 blood cultures obtained using the ISDD there were zero contaminants found (BCC rate 0%) versus 29 contaminated sets using traditional methods (BCC rate 3.15%). Twenty-eight contaminants were observed from nursing staff blood culture draws (BCC rate 1.98%). Zero false-positive CLABSIs were associated with use of the ISDD for the trial period. No matched sets containing 1 of 4 bottles with VRE or Candida sp. were observed. Table Stanford Health Care blood culture collection methods and contamination events (March 15, 2019 - July 21, 2019) Conclusion The trial results encourage adoption of the ISDD as standard practice for blood culture at SHC. Disclosures All Authors: No reported disclosures

scholarly journals Antimicrobial Stewardship Standards and Patient Safety: A Case Study in Blood Culture Contamination

2021 ◽  
Vol 1 (S1) ◽  
pp. s36-s36
Author(s):  
Connie Schaefer
Keyword(s):  
Blood Culture ◽  
Healthcare System ◽  
Antimicrobial Stewardship ◽  
Standard Method ◽  
Broad Spectrum ◽  
Emergency Departments ◽  
Blood Cultures ◽  
Contamination Rate ◽  
Broad Spectrum Antibiotics ◽  
Contamination Events

Background: Blood culture is a crucial diagnostic tool for healthcare systems, but false-positive results drain clinical resources, imperil patients with an increased length of stay (and associated hospital-acquired infection risk), and undermine global health initiatives when broad-spectrum antibiotics are administered unnecessarily. Considering emerging technologies that mitigate human error factors, we questioned historically acceptable rates of blood culture contamination, which prompted a need to promote and trial these technologies further. In a 3-month trial, 3 emergency departments in a midwestern healthcare system utilized an initial specimen diversion device (ISDD) to draw blood cultures to bring their blood culture contamination rate (4.4% prior to intervention) below the 3% benchmark recommended by the Clinical & Laboratory Standards Institute. Methods: All emergency department nursing staff received operational training on the ISDD for blood culture sample acquisition. From June through August 2019, 1,847 blood cultures were drawn via the ISDD, and 862 were drawn via the standard method. Results: In total, 16 contamination events occurred when utilizing the ISDD (0.9%) and 37 contamination events occurred when utilizing the standard method (4.3%). ISDD utilization resulted in an 80% reduction in blood culture contamination from the rate of 4.4% rate held prior to intervention. Conclusions: A midwestern healthcare system experienced a dramatic reduction in blood culture contamination across 3 emergency departments while pilot testing an ISDD, conserving laboratory and therapeutic resources while minimizing patient exposure to unnecessary risks and procedures. If the results obtained here were sustained and the ISDD utilized for all blood culture draws, nearly 400 contamination events could be avoided annually in this system. Reducing unnecessary antibiotic use in this manner will lower rates of associated adverse events such as acute kidney injury and allergic reaction, which are possible topics for further investigation. The COVID-19 pandemic has recently highlighted both the importance of keeping hospital beds available and the rampant carelessness with which broad-spectrum antibiotics are administered (escalating the threat posed by multidrug-resistant organisms). As more ambitious healthcare benchmarks become attainable, promoting and adhering to higher standards for patient care will be critical to furthering an antimicrobial stewardship agenda and to reducing treatment inequity in the field.Funding: NoDisclosures: None

scholarly journals Comparison of the Contamination Rate and Risk Factor Profile of Blood Culture Done in Emergency Department and MHDU/MICUs

2021 ◽  
pp. 1-8
Author(s):  
Dr. Pankaj Kumar Singh
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Risk Factor ◽  
Blood Culture ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Contamination Rate ◽  
Medical Illness ◽  
Inclusion Criteria ◽  
Factors Associated

Aims and objectives: To determine the risk factors of blood culture contamination done in ED and those done in the MHDU/MICU among patients admitted with medical illness. Material and Methods: This is a two months’ prospective observational study comparing blood culture contamination rate and risk factors associated with contamination between ED and MICU/MHDU. A total of 998 patients were included in the study who underwent blood culture in ED and MICU/MHDU. 570 in ED and 428 in MICU/MHDU were included after meeting exclusion and inclusion criteria. Results: Blood culture growths were higher in ED (19%). Most common growth was CoNS (4%). The overall contamination rate in this study was (4.8%) The contamination rate was lower in ED (4.4%) when compared to MICU/MHDU (5.4%).

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