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

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.

Download Full-text

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

Scientific Reports ◽

10.1038/s41598-021-00498-x ◽

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.

Download Full-text

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

Global Journal of Medical Research ◽

10.34257/mrcvol21is2pg1 ◽

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%).

Download Full-text

Identifying early surrogate markers for blood culture positive sepsis in an urban NICU-A retrospective observational study

IP International Journal of Medical Paediatrics and Oncology ◽

10.18231/j.ijmpo.2021.007 ◽

2021 ◽

Vol 7 (1) ◽

pp. 28-35

Author(s):

Uma Raju ◽

Arnab Sengupta ◽

Vishnu Tej ◽

Rupesh Bansal ◽

N Saravanan ◽

...

Keyword(s):

Blood Culture ◽

Observational Study ◽

Retrospective Observational Study ◽

Surrogate Markers ◽

Culture Positive

Download Full-text

Need of the hour? does breast milk bank reduces perinatal morbidity and mortality: a retrospective observational study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20200103 ◽

2020 ◽

Vol 7 (2) ◽

pp. 327

Author(s):

Narayanan E. ◽

Mohd Sajjid ◽

Arun Kumar

Keyword(s):

Breast Milk ◽

Observational Study ◽

Human Milk ◽

Morbidity And Mortality ◽

Retrospective Observational Study ◽

P Value ◽

Contamination Rate ◽

Milk Bank ◽

Mortality Outcome ◽

Human Milk Bank

Background: Human milk bank plays an essential role by providing human milk to infants who would otherwise not be able to receive human milk. The aims and Objectives is to study the morbidity and mortality outcome profile of babies fed with PDHM (pasteurized donor human milk) comparing data between Pre Human Milk Breast bank (2015) and Post Human Milk Breast bank (2016, 2017 and 2018).Methods: Milk bank collect, screen, store, process, and distribute human milk. Retrospective observational study was done in Department of Neonatology, Institute of Obstetrics and Gynaecology and Women and Children Hospital, Chennai. Data obtained retrospectively comparing data Pre HMB (2015) and Post HMB (2016, 2017 and 2018).Results: In this study authors collected the data comparing Pre human milk bank (Pre HMB) and Post human milk bank (Post HMB). After starting human milk bank, around 1799 babies were benefitted and 14.45 lakh ml milk was collected from 16000 donor mothers in last 3 years. Bacterial contamination rate of PDHM has reduced to 4.39% (2018) compared to 7.73% (2016) with P Value 0.0042 (statistically significant). CONS and Staphylococcus aureus were the most common Organisms isolated. There was reduction in morbidity profile like sepsis rate, NEC/ Feed intolerance and ROP profile. Mortality profile also reduced to (7.73-9.31%). Duration of hospital and Duration to attain full feeds were improved all GA group babies.Conclusions: In this study, after starting human milk bank there was reduction in mortality, morbidity outcome, sepsis. Duration to attain full feeds and duration of hospital stay reduced. We concluded that establishment of breast milk bank will be more useful and beneficial for all GA group babies for better outcome.

Download Full-text

Using machine learning to predict blood culture outcomes in the emergency department: a single-centre, retrospective, observational study

BMJ Open ◽

10.1136/bmjopen-2021-053332 ◽

2022 ◽

Vol 12 (1) ◽

pp. e053332

Author(s):

Anneroos W Boerman ◽

Michiel Schinkel ◽

Lotta Meijerink ◽

Eva S van den Ende ◽

Lara CA Pladet ◽

...

Keyword(s):

Emergency Department ◽

Logistic Regression ◽

Blood Culture ◽

Observational Study ◽

Retrospective Observational Study ◽

True Positive ◽

Single Centre ◽

Tree Model ◽

Ed Visits ◽

Boosted Tree

ObjectivesTo develop predictive models for blood culture (BC) outcomes in an emergency department (ED) setting.DesignRetrospective observational study.SettingED of a large teaching hospital in the Netherlands between 1 September 2018 and 24 June 2020.ParticipantsAdult patients from whom BCs were collected in the ED. Data of demographic information, vital signs, administered medications in the ED and laboratory and radiology results were extracted from the electronic health record, if available at the end of the ED visits.Main outcome measuresThe primary outcome was the performance of two models (logistic regression and gradient boosted trees) to predict bacteraemia in ED patients, defined as at least one true positive BC collected at the ED.ResultsIn 4885 out of 51 399 ED visits (9.5%), BCs were collected. In 598/4885 (12.2%) visits, at least one of the BCs was true positive. Both a gradient boosted tree model and a logistic regression model showed good performance in predicting BC results with area under curve of the receiver operating characteristics of 0.77 (95% CI 0.73 to 0.82) and 0.78 (95% CI 0.73 to 0.82) in the test sets, respectively. In the gradient boosted tree model, the optimal threshold would predict 69% of BCs in the test set to be negative, with a negative predictive value of over 94%.ConclusionsBoth models can accurately identify patients with low risk of bacteraemia at the ED in this single-centre setting and may be useful to reduce unnecessary BCs and associated healthcare costs. Further studies are necessary for validation and to investigate the potential clinical benefits and possible risks after implementation.

Download Full-text

Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

Hämostaseologie ◽

10.1055/s-0037-1619773 ◽

2012 ◽

Vol 32 (S 01) ◽

pp. S39-S42 ◽

Cited By ~ 1

Author(s):

S. Kocher ◽

G. Asmelash ◽

V. Makki ◽

S. Müller ◽

S. Krekeler ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Observational Study ◽

Retrospective Observational Study ◽

Frequent Change ◽

Patient Age ◽

Treatment Regimens ◽

Patient Âgé ◽

The Relationship ◽

Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

Download Full-text