Taking blood cultures from a newly established intravenous catheter in the emergency department does not increase the rate of contaminated blood cultures

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Anne-Maree Kelly ◽  
Sharon Klim
Keyword(s):  
Emergency Department ◽  
Blood Cultures ◽  
Intravenous Catheter ◽  
Contaminated Blood

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 Blood Culture Collection through Peripheral Intravenous Catheters Increases the Risk of Specimen Contamination among Adult Emergency Department Patients

2012 ◽  
Vol 33 (5) ◽  
pp. 524-526 ◽  
Author(s):  
Wesley H. Self ◽  
Theodore Speroff ◽  
Candace D. McNaughton ◽  
Patty W. Wright ◽  
Geraldine Miller ◽  
...  
Keyword(s):  
Emergency Department ◽  
Relative Risk ◽  
Blood Culture ◽  
Confidence Interval ◽  
Culture Collection ◽  
Blood Cultures ◽  
Intravenous Catheter ◽  
Peripheral Intravenous Catheter ◽  
Emergency Department Patients ◽  
Intravenous Catheters

Five hundred five blood cultures collected through a peripheral intravenous catheter (PIV) in an emergency department were matched to cultures obtained by dedicated venipuncture from the same patient within 10 minutes. The relative risk of contamination for cultures collected through PIVs compared with dedicated venipuncture was 1.83 (95% confidence interval, 1.08–3.11).

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 2080. Impact of an Emergency Department Post-discharge Blood Culture Follow-up Program

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S701-S702
Author(s):  
Axel Vazquez Deida ◽  
Veronica Salazar ◽  
Lilly Lee ◽  
Lilian Abbo
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Phase 1 ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Low Risk ◽  
Phase 2 ◽  
Post Discharge ◽  
Contaminated Blood

Abstract Background Blood cultures are the gold standard in the identification of laboratory confirmed bloodstream infections (LCBI) but contamination can lead to unnecessary interventions. This study sought to assess the number of unwarranted admissions in patients with contaminated blood cultures post-discharge and at low risk for LCBI before and after the implementation of a multidisciplinary emergency department (ED) blood culture follow-up program. Methods This was a two-phase retrospective cohort study at a tertiary care, 1,550-bed, academic hospital and level I trauma center in southeast Florida. Phase 1 assessed interventions made on patients 18 years of age or older discharged from the ED or a hospital observation unit with a positive blood culture result post-discharge from March 2018 to July 2018. Phase 2 assessed interventions made from December 2018 to March 2019 post-implementation of the multidisciplinary follow-up program. The criteria for low risk of LCBI were lack of risk factors for infection and < 2 positive blood cultures with a commensal bacteria with no symptoms of fever or hypotension on the date of specimen collection and 3 days before or after such date. Results Among patients at low risk for LCBI (46% of 24 patients in phase 1 vs. 59% of 22 patients in phase 2), unwarranted admissions due to contaminated blood cultures occurred in 27.3% of patients in phase 1 vs. 0% of patients in phase 2 (P = 0.08). Phase 1 represented a period in which systematic reporting and evaluation of positive results and patient follow-up were not in place. Phase 2 consisted of daily pharmacist-led blood culture reviews with callback nurse follow-up and therapeutic care plan development with ED physicians. The number of contaminant isolates was relatively high (Figures 1 and 2). Pharmacist-led interventions were diverse (Figure 3). The program led to an estimated total cost avoidance of $16,410.80 in a median of 4.5 months due to unnecessary admissions. Conclusion Implementation of a multidisciplinary ED post-discharge blood culture follow-up program can be an effective strategy in improving patient care and avoiding unnecessary antibiotic therapy. Further interventions aimed at reducing blood culture contamination could have a direct impact on improving ED antimicrobial stewardship. Disclosures All authors: No reported disclosures.

Ability of procalcitonin to differentiate true bacteraemia from contaminated blood cultures in an emergency department

2019 ◽  
Vol 37 (9) ◽  
pp. 560-568
Author(s):  
Sadaf Zafar Iqbal-Mirza ◽  
Vicente Serrano Romero de Ávila ◽  
Raquel Estévez-González ◽  
Dara Rodríguez-González ◽  
Eva Heredero-Gálvez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Cultures ◽  
Contaminated Blood

scholarly journals Chryseobacterium bacteraemia in a patient with heart failure: case report and literature review

2020 ◽  
Author(s):  
Taylor Wood ◽  
Antonio Abbate ◽  
Inna Tchoukina ◽  
Michael P Stevens
Keyword(s):  
Emergency Department ◽  
Human Infection ◽  
Blood Cultures ◽  
Vasopressor Therapy ◽  
Duration Of Treatment ◽  
Chryseobacterium Indologenes ◽  
Case Summary ◽  
Biventricular Failure ◽  
Heart Failure Case ◽  
Antimicrobial Regimen

Abstract Background A 29-year-old male with recently diagnosed biventricular failure from myopericarditis and subsequent constrictive pericarditis on home milrinone presented to the Emergency Department with fevers/chills. Case summary On arrival to the Emergency Department, he was found to have septic shock and required vasopressor therapy. Chryseobacterium indologenes grew on his admission blood cultures, and he was treated with ciprofloxacin and piperacillin/tazobactam. He quickly improved, allowing for a successful pericardiectomy, was weaned off inotropes and discharged from the hospital. Discussion Chryseobacterium indologenes is an environmental Gram-negative rod found in groundwater. It is rarely associated with human infection, but is associated with indwelling lines and has been documented in immunocompromised patients. Treatment typically involves line removal and a fluoroquinolone or piperacillin/tazobactam; the most optimal antimicrobial regimen and duration of treatment are unknown.

Risk factors and clinical outcomes associated with blood culture contamination

2021 ◽  
pp. 1-7
Author(s):  
Justin M. Klucher ◽  
Kevin Davis ◽  
Mrinmayee Lakkad ◽  
Jacob T. Painter ◽  
Ryan K. Dare
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Hospital Charges ◽  
Patient Specific ◽  
Contaminated Blood

Abstract Objective: To determine patient-specific risk factors and clinical outcomes associated with contaminated blood cultures. Design: A single-center, retrospective case-control risk factor and clinical outcome analysis performed on inpatients with blood cultures collected in the emergency department, 2014–2018. Patients with contaminated blood cultures (cases) were compared to patients with negative blood cultures (controls). Setting: A 509-bed tertiary-care university hospital. Methods: Risk factors independently associated with blood-culture contamination were determined using multivariable logistic regression. The impacts of contamination on clinical outcomes were assessed using linear regression, logistic regression, and generalized linear model with γ log link. Results: Of 13,782 blood cultures, 1,504 (10.9%) true positives were excluded, leaving 1,012 (7.3%) cases and 11,266 (81.7%) controls. The following factors were independently associated with blood-culture contamination: increasing age (adjusted odds ratio [aOR], 1.01; 95% confidence interval [CI], 1.01–1.01), black race (aOR, 1.32; 95% CI, 1.15–1.51), increased body mass index (BMI; aOR, 1.01; 95% CI, 1.00–1.02), chronic obstructive pulmonary disease (aOR, 1.16; 95% CI, 1.02–1.33), paralysis (aOR 1.64; 95% CI, 1.26–2.14) and sepsis plus shock (aOR, 1.26; 95% CI, 1.07–1.49). After controlling for age, race, BMI, and sepsis, blood-culture contamination increased length of stay (LOS; β = 1.24 ± 0.24; P < .0001), length of antibiotic treatment (LOT; β = 1.01 ± 0.20; P < .001), hospital charges (β = 0.22 ± 0.03; P < .0001), acute kidney injury (AKI; aOR, 1.60; 95% CI, 1.40–1.83), echocardiogram orders (aOR, 1.51; 95% CI, 1.30–1.75) and in-hospital mortality (aOR, 1.69; 95% CI, 1.31–2.16). Conclusions: These unique risk factors identify high-risk individuals for blood-culture contamination. After controlling for confounders, contamination significantly increased LOS, LOT, hospital charges, AKI, echocardiograms, and in-hospital mortality.

scholarly journals Swimming with the Pigs: A Case of Severe Soft Tissue Infection during a Caribbean Vacation

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Alexandra W. Dretler ◽  
Jesse T. Jacob ◽  
Nadine G. Rouphael
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Activities Of Daily Living ◽  
Soft Tissue Infection ◽  
Daily Living ◽  
Complete Resolution ◽  
Surgical Intervention ◽  
Blood Cultures ◽  
The Bahamas ◽  
Severe Soft Tissue

A 74-year-old man presented to the emergency department with severe right leg cellulitis following a trip to the Bahamas where he swam in both chlorinated pools and the ocean. His blood cultures grew Shewanella species, a marine pathogen known to cause disease in humans, following exposure to seawater. He was treated with cefepime for a total of two weeks without needing any surgical intervention. The patient had complete resolution of infection and was able to return to his activities of daily living.

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