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Reducing Blood Culture Contamination by a Simple Informational Intervention

Roth, Adam LU ; Wiklund, A. E.; Palsson, A. S.; Melander, Eva LU ; Wullt, Marlene LU ; Cronqvist, Jonas LU ; Walder, Mats LU and Sturegård, Erik LU (2010) In Journal of Clinical Microbiology 48(12). p.4552-4558
Abstract
Compared to truly negative cultures, false-positive blood cultures not only increase laboratory work but also prolong lengths of patient stay and use of broad-spectrum antibiotics, both of which are likely to increase antibiotic resistance and patient morbidity. The increased patient suffering and surplus costs caused by blood culture contamination motivate substantial measures to decrease the rate of contamination, including the use of dedicated phlebotomy teams. The present study evaluated the effect of a simple informational intervention aimed at reducing blood culture contamination at Skane University Hospital (SUS), Malmo, Sweden, during 3.5 months, focusing on departments collecting many blood cultures. The main examined outcomes of... (More)
Compared to truly negative cultures, false-positive blood cultures not only increase laboratory work but also prolong lengths of patient stay and use of broad-spectrum antibiotics, both of which are likely to increase antibiotic resistance and patient morbidity. The increased patient suffering and surplus costs caused by blood culture contamination motivate substantial measures to decrease the rate of contamination, including the use of dedicated phlebotomy teams. The present study evaluated the effect of a simple informational intervention aimed at reducing blood culture contamination at Skane University Hospital (SUS), Malmo, Sweden, during 3.5 months, focusing on departments collecting many blood cultures. The main examined outcomes of the study were pre- and postintervention contamination rates, analyzed with a multivariate logistic regression model adjusting for relevant determinants of contamination. A total of 51,264 blood culture sets were drawn from 14,826 patients during the study period (January 2006 to December 2009). The blood culture contamination rate preintervention was 2.59% and decreased to 2.23% postintervention (odds ratio, 0.86; 95% confidence interval, 0.76 to 0.98). A similar decrease in relevant bacterial isolates was not found postintervention. Contamination rates at three auxiliary hospitals did not decrease during the same period. The effect of the intervention on phlebotomists' knowledge of blood culture routines was also evaluated, with a clear increase in level of knowledge among interviewed phlebotomists postintervention. The present study shows that a relatively simple informational intervention can have significant effects on the level of contaminated blood cultures, even in a setting with low rates of contamination where nurses and auxiliary nurses conduct phlebotomies. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Microbiology
volume
48
issue
12
pages
4552 - 4558
publisher
American Society for Microbiology
external identifiers
  • wos:000284693400032
  • scopus:78650061018
ISSN
1098-660X
DOI
10.1128/JCM.00877-10
language
English
LU publication?
yes
id
34581cff-3bed-40be-8c37-64b3c6afdd42 (old id 1752162)
date added to LUP
2011-01-04 07:45:05
date last changed
2018-06-03 04:10:41
@article{34581cff-3bed-40be-8c37-64b3c6afdd42,
  abstract     = {Compared to truly negative cultures, false-positive blood cultures not only increase laboratory work but also prolong lengths of patient stay and use of broad-spectrum antibiotics, both of which are likely to increase antibiotic resistance and patient morbidity. The increased patient suffering and surplus costs caused by blood culture contamination motivate substantial measures to decrease the rate of contamination, including the use of dedicated phlebotomy teams. The present study evaluated the effect of a simple informational intervention aimed at reducing blood culture contamination at Skane University Hospital (SUS), Malmo, Sweden, during 3.5 months, focusing on departments collecting many blood cultures. The main examined outcomes of the study were pre- and postintervention contamination rates, analyzed with a multivariate logistic regression model adjusting for relevant determinants of contamination. A total of 51,264 blood culture sets were drawn from 14,826 patients during the study period (January 2006 to December 2009). The blood culture contamination rate preintervention was 2.59% and decreased to 2.23% postintervention (odds ratio, 0.86; 95% confidence interval, 0.76 to 0.98). A similar decrease in relevant bacterial isolates was not found postintervention. Contamination rates at three auxiliary hospitals did not decrease during the same period. The effect of the intervention on phlebotomists' knowledge of blood culture routines was also evaluated, with a clear increase in level of knowledge among interviewed phlebotomists postintervention. The present study shows that a relatively simple informational intervention can have significant effects on the level of contaminated blood cultures, even in a setting with low rates of contamination where nurses and auxiliary nurses conduct phlebotomies.},
  author       = {Roth, Adam and Wiklund, A. E. and Palsson, A. S. and Melander, Eva and Wullt, Marlene and Cronqvist, Jonas and Walder, Mats and Sturegård, Erik},
  issn         = {1098-660X},
  language     = {eng},
  number       = {12},
  pages        = {4552--4558},
  publisher    = {American Society for Microbiology},
  series       = {Journal of Clinical Microbiology},
  title        = {Reducing Blood Culture Contamination by a Simple Informational Intervention},
  url          = {http://dx.doi.org/10.1128/JCM.00877-10},
  volume       = {48},
  year         = {2010},
}