Sites of Blood Collection and Topical Disinfectants Associated with Contaminated Cultures: An Ambidirectional Cohort Study

2021 ◽  
Author(s):  
Koshi Ota ◽  
Daisuke Nishioka ◽  
Yuri Ito ◽  
Emi Hamada ◽  
Kanna Ota ◽  
...  
Keyword(s):  
Cohort Study ◽  
Risk Difference ◽  
Blood Cultures ◽  
University Hospital ◽  
Blood Collection ◽  
True Negative ◽  
Adjusted Risk ◽  
Negative Results ◽  
Contaminated Blood ◽  
Aerobic And Anaerobic

Abstract Background: We aimed to determine whether puncture sites for blood sampling and topical disinfectants are associated with rates of contaminated blood cultures in the emergency department (ED) of a single institution.Methods: This single-center, ambidirectional cohort study of 548 consecutive patients ≥ 20 years old was performed in the ED of a university hospital in Japan over a 13-month period. Pairs of blood samples were collected for aerobic and anaerobic cultures from patients in the ED. Physicians selected puncture sites and topical disinfectants according to their personal preference.Results: Potential contamination was identified in 110 of the 548 patients (20.1%). One hundred fourteen (20.8%) patients showed true-positive results for bacteremia and 324 (59.1%) patients showed true-negative results. Multivariate analysis revealed more frequent contamination when puncture sites were disinfected with povidone-iodine (PVI) than with alcohol/chlorhexidine (ACHX) (adjusted risk difference, 19.1%; 95% confidence interval [CI]), 15.7–22.6; P < 0.001). In terms of blood collection sites, femoral and central venous (CV) catheter with PVI disinfection showed more frequent contamination than venous sites with ACHX (adjusted risk differences: 26.6%, 95%CI 21.3–31.9, P < 0.001 and 41.1%, 95%CI 22.2–59.9, P < 0.001, respectively).Conclusions: Rates of contaminated blood cultures were significantly higher when blood was collected from CV catheter or femoral sites with PVI as the topical disinfectant.

scholarly journals Sites of blood collection and topical antiseptics associated with contaminated cultures: prospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Koshi Ota ◽  
Koji Oba ◽  
Keisuke Fukui ◽  
Yuri Ito ◽  
Emi Hamada ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Povidone Iodine ◽  
Risk Difference ◽  
Blood Cultures ◽  
University Hospital ◽  
Blood Collection ◽  
Adjusted Risk ◽  
Contaminated Blood ◽  
Aerobic And Anaerobic

AbstractWe aimed to determine whether puncture sites for blood sampling and topical disinfectants are associated with rates of contaminated blood cultures in the emergency department (ED) of a single institution. This single-center, prospective observational study of 249 consecutive patients aged ≥ 20 years proceeded in the ED of a university hospital in Japan during 6 months. Pairs of blood samples were collected for aerobic and anaerobic culture from all patients in the ED. Physicians selected puncture sites and topical disinfectants according to their personal preference. We found 50 (20.1%) patients with potentially contaminated blood cultures. Fifty-six (22.5%) patients were true bacteremia and 143 (57.4%) patients were true negatives. Multivariate analysis associated more frequent contamination when puncture sites were disinfected with povidone-iodine than with alcohol/chlorhexidine (adjusted risk difference, 12.9%; 95% confidence interval [CI] 8.8–16.9; P < 0.001). Sites of blood collection were also associated with contamination. Femoral and central venous with other sites were associated with contamination more frequently than venous sites (adjusted risk difference), 13.1% (95% CI 8.2–17.9; P < 0.001]) vs. 17.3% (95% CI 3.6–31.0; P = 0.013). Rates of contaminated blood cultures were significantly higher when blood was collected from femoral sites and when povidone-iodine was the topical antiseptic.

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 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 Health vigilance concerning Acinetobacter baumannii bacteremia at the mohammed VI university hospital of oujda (morocco): epidemiological profile and antibiotic resistance

2021 ◽  
Vol 319 ◽  
pp. 01003
Author(s):  
Loubna Yacoubi ◽  
Soumia Farih ◽  
Noussaiba Benhamza ◽  
Abderazzak Seddari ◽  
Adil maleb
Keyword(s):  
Antibiotic Resistance ◽  
Blood Cultures ◽  
University Hospital ◽  
Microbiology Laboratory ◽  
Prevention Measures ◽  
Control And Prevention ◽  
Epidemiological Profile ◽  
Healthcare Associated ◽  
Resistance Rates ◽  
Contaminated Blood

The objective of this work is to determine the epidemiological profile of Acinetobacter b aumannii (A.baumannii ) bacteremia in the microbiology laboratory of CHU Mohammed VI of Oujda and its antibiotic resistance rates. This is a retrospective and descriptive study of 27 months from June 24, 2016to September 19, 2018 including all positive blood cultures processed in the microbiology laboratory in accordance with REMIC (reference in medical microbiology)and EUCAST(European Committee on Antimicrobial Susceptibility Testing). Contaminated blood cultures were excluded. As results we collected 863 positive blood cultures, A. baumannii accounted for 7.41% (n = 64). 67% (n =43) of the strains were isolated from patients hospitalized in intensive care (adults, children and newborns). The two main risk factors described in patients with our series were wearing of intravascular device in 55% (n=35) Immunosuppression in 22% n=14). A. baumannii bacteremia was associated with care in 37.5% (n=24). 75% (n=48) of A. baumannii isolates were resistant to carbapenems. No strain of A. baumannii was resistant to colistin. In light of these results strengthening the control and prevention measures for healthcare associated infections would be the most reliable way to limit the spread of A. baumannii in our establishment.

scholarly journals Do cannabis and urbanicity co-participate in causing psychosis? Evidence from a 10-year follow-up cohort study

2011 ◽  
Vol 41 (10) ◽  
pp. 2121-2129 ◽  
Author(s):  
R. Kuepper ◽  
J. van Os ◽  
R. Lieb ◽  
H.-U. Wittchen ◽  
C. Henquet
Keyword(s):  
Cohort Study ◽  
Urban Environment ◽  
Developmental Stages ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Risk Difference ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Adjusted Risk

BackgroundCannabis use is considered a component cause of psychotic illness, interacting with genetic and other environmental risk factors. Little is known, however, about these putative interactions. The present study investigated whether an urban environment plays a role in moderating the effects of adolescent cannabis use on psychosis risk.MethodProspective data (n=1923, aged 14–24 years at baseline) from the longitudinal population-based German Early Developmental Stages of Psychopathology cohort study were analysed. Urbanicity was assessed at baseline and defined as living in the city of Munich (1562 persons per km2; 4061 individuals per square mile) or in the rural surroundings (213 persons per km2; 553 individuals per square mile). Cannabis use and psychotic symptoms were assessed three times over a 10-year follow-up period using the Munich version of the Composite International Diagnostic Interview.ResultsAnalyses revealed a significant interaction between cannabis and urbanicity [10.9% adjusted difference in risk, 95% confidence interval (CI) 3.2–18.6, p=0.005]. The effect of cannabis use on follow-up incident psychotic symptoms was much stronger in individuals who grew up in an urban environment (adjusted risk difference 6.8%, 95% CI 1.0–12.5, p=0.021) compared with individuals from rural surroundings (adjusted risk difference −4.1%, 95% CI −9.8 to 1.6, p=0.159). The statistical interaction was compatible with substantial underlying biological synergism.ConclusionsExposure to environmental influences associated with urban upbringing may increase vulnerability to the psychotomimetic effects of cannabis use later in life.

scholarly journals Blood Cultures for the Diagnosis of Infective Endocarditis: What Is the Benefit of Prolonged Incubation?

2021 ◽  
Vol 10 (24) ◽  
pp. 5824
Author(s):  
Vincent Fihman ◽  
Hélène Faury ◽  
Amina Moussafeur ◽  
Raphaelle Huguet ◽  
Adrien Galy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Retrospective Cohort ◽  
Blood Cultures ◽  
University Hospital ◽  
Infectious Endocarditis ◽  
Prolonged Incubation ◽  
Cutibacterium Acnes

To assess the need for prolonged incubation of blood culture bottles beyond five days for the diagnosis of infectious endocarditis (IE), we conducted a retrospective cohort study of 6109 sets of two blood culture bottles involving 1211 patients admitted to the Henri Mondor University Hospital for suspicion of IE between 1 January 2016 and 31 December 2019. Among the 322 patients with IE, 194 had positive blood cultures in our centre. Only one patient with a time-to-positivity blood culture of more than 120 h (5 days) was found. The main cause for the 22 patients with positive blood cultures after five days was contamination with Cutibacterium acnes. Our results do not support extending the duration of incubation of blood culture bottles beyond five days for the diagnosis of infectious endocarditis, with the exception of patients with risk factors for C. acnes infection.

scholarly journals Controlled Clinical Laboratory Comparison of Two Supplemented Aerobic and Anaerobic Media Used in Automated Blood Culture Systems To Detect Bloodstream Infections

1998 ◽  
Vol 36 (3) ◽  
pp. 657-661 ◽  
Author(s):  
R. Ziegler ◽  
I. Johnscher ◽  
P. Martus ◽  
D. Lenhardt ◽  
H.-M. Just
Keyword(s):  
Blood Culture ◽  
Clinical Laboratory ◽  
False Positive Rate ◽  
False Negative ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Negative Results ◽  
Two Systems ◽  
Time To Detection ◽  
Aerobic And Anaerobic

A 20-ml blood sample was collected from adult patients with suspected bloodstream infections and distributed equally into the four volume-controlled bottles of a blood culture set consisting of aerobic and anaerobic BACTEC Plus/F bottles and aerobic and anaerobic BacT/Alert FAN bottles. All bottles were incubated in their respective instruments for a standard 5-day protocol or until the instruments signalled positivity. Samples in all bottles with negative results by these instruments were terminally subcultured. A total of 8,390 blood culture sets were obtained during the study period, of which 4,402 (52.5%) met the study criteria. Of these, 946 (21.5%) were positive either by instrument signal or by additional terminal subculture of all negative bottles and yielded growth of microorganisms. Five hundred eighty-nine (13.4%) blood culture sets were considered to have recovered 663 clinically significant organisms. When both the BACTEC and the BacT/Alert systems were used, 465 positive sets were detected; BACTEC alone detected 52 positive sets and BacT/Alert alone detected 72 (P = 0.09). No differences were found between the two systems in microbial recovery rate from blood cultures obtained from patients on antibiotic therapy. Significantly more members of the family Enterobacteriaceae (P < 0.01) were detected from patients without antimicrobial therapy by BacT/Alert than by BACTEC. The false-negative rates were 0.20% for BACTEC and 0.32% for BacT/Alert. A significantly higher false-positive rate was found for BACTEC (P < 0.0001). Both systems were comparable for the time to detection of microorganisms. However, gram-positive bacteria were detected faster by BACTEC andEnterobacteriaceae were detected faster on average by BacT/Alert. We concluded that both systems are comparable in their abilities to recover aerobic and anaerobic organisms from blood cultures and a terminal subculture might not be necessary for either of the two systems. The increased positivity rate when using an anaerobic bottle in a two-bottle blood culture set is due to the additional blood volume rather than to the use of an anaerobic medium.

The role of serum periostin in the diagnosis of asthma: A meta-analysis

2020 ◽  
Vol 41 (4) ◽  
pp. 240-247
Author(s):  
Lei Yang ◽  
Qingtao Zhao ◽  
Shuyu Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Negative Results ◽  
Noninvasive Biomarker ◽  
Sensitivity Specificity ◽  
Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

scholarly journals Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital

2021 ◽  
Vol 18 (14) ◽  
pp. 7528
Author(s):  
Nagham Khanafer ◽  
Philippe Vanhems ◽  
Sabrina Bennia ◽  
Géraldine Martin-Gaujard ◽  
Laurent Juillard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clostridium Difficile ◽  
Good Clinical Practice ◽  
University Hospital ◽  
Factors Associated ◽  
Contact Precautions ◽  
Institutional Review ◽  
Virulent Strains ◽  
Scientific Meetings ◽  
Hospital Acquired

Introduction: Clostridioides (Clostridium) difficile can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. C. difficile, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from C. difficile infection (CDI). However, asymptomatic colonized patients are not targeted by infection control policies, and active surveillance for colonization is not routinely performed. Moreover, given the current changes in the epidemiology of CDI, particularly the emergence of new virulent strains either in the hospital or community settings, there is a need for identification of factors associated with colonization by C. difficile and CDI. Methods and analysis: We are carrying out a prospective, observational, cohort study in Edouard Herriot Hospital, Hospices Civils de Lyon, a 900-bed university hospital in Lyon, France. All consecutive adult patients admitted on selected units are eligible to participate in the study. Stool samples or rectal swabs for C. difficile testing are obtained on admission, every 3–5 days during hospitalization, at the onset of diarrhea (if applicable), and at discharge. Descriptive and logistic regression analyses will be completed to mainly estimate the proportion of asymptomatic colonization at admission, and to evaluate differences between factors associated with colonization and those related to CDI. Ethics: The study is conducted in accordance with the ethical principles of the Declaration of Helsinki, French law, and the Good Clinical Practice guidelines. The study protocol design was approved by the participating units, the ethics committee and the hospital institutional review board (Comité de protection des personnes et Comission Nationale de l’Informatique et des Libertés; N°: 00009118). Dissemination: The results of this study will be disseminated by presenting the findings locally at each participating ward, as well as national and international scientific meetings. Findings will be shared with interested national societies crafting guidelines in CDI.

scholarly journals A multicenter, hospital-based and non-inferiority study for diagnostic efficacy of automated whole breast ultrasound for breast cancer in China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yujing Xin ◽  
Xinyuan Zhang ◽  
Yi Yang ◽  
Yi Chen ◽  
Yanan Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
False Negative ◽  
Final Analysis ◽  
Age Group ◽  
Surgical Biopsy ◽  
True Negative ◽  
Diagnostic Efficacy ◽  
Negative Results ◽  
Informed Consent Form ◽  
Magnetic Resonance Imaging Mri

AbstractThis study is the first multi-center non-inferiority study that aims to critically evaluate the effectiveness of HHUS/ABUS in China breast cancer detection. This was a multicenter hospital-based study. Five hospitals participated in this study. Women (30–69 years old) with defined criteria were invited for breast examination by HHUS, ABUS or/and mammography. For BI-RADS category 3, an additional magnetic resonance imaging (MRI) test was provided to distinguish the true negative results from false negative results. For women classified as BI-RADS category 4 or 5, either core aspiration biopsy or surgical biopsy was done to confirm the diagnosis. Between February 2016 and March 2017, 2844 women signed the informed consent form, and 1947 of them involved in final analysis (680 were 30 to 39 years old, 1267 were 40 to 69 years old).For all participants, ABUS sensitivity (91.81%) compared with HHUS sensitivity (94.70%) with non-inferior Z tests, P = 0.015. In the 40–69 age group, non-inferior Z tests showed that ABUS sensitivity (93.01%) was non-inferior to MG sensitivity (86.02%) with P < 0.001 and HHUS sensitivity (95.44%) was non-inferior to MG sensitivity (86.02%) with P < 0.001. Sensitivity of ABUS and HHUS are all superior to that of MG with P < 0.001 by superior test.For all participants, ABUS specificity (92.89%) was non-inferior to HHUS specificity (89.36%) with P < 0.001. Superiority test show that specificity of ABUS was superior to that of HHUS with P < 0.001. In the 40–69 age group, ABUS specificity (92.86%) was non-inferior to MG specificity (91.68%) with P < 0.001 and HHUS specificity (89.55%) was non-inferior to MG specificity (91.68%) with P < 0.001. ABUS is not superior to MG with P = 0.114 by superior test. The sensitivity of ABUS/HHUS is superior to that of MG. The specificity of ABUS/HHUS is non-inferior to that of MG. In China, for an experienced US radiologist, both HHUS and ABUS have better diagnostic efficacy than MG in symptomatic individuals.

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