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Blood collection procedures influence contamination rates in blood culture: a prospective study
Ying Ge1, Xiao-Qing Liu, Ying-Chun Xu
1Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Background:
Blood culture contamination is a significant adverse event. The aim of this project was to evaluate the efficacy of a strict blood collection procedure in reducing the blood culture contamination rate.
Methods:
A prospectively controlled study was performed in two different medical areas in Peking Union Medical College Hospital (PUMCH) for 16 months (from May 2006 to September 2007). In test group, a strict blood collection procedure was carried out by trained nurses with the veinpuncture sites were scrupulously disinfected with 2.5% tincture of iodine plus 70% alcohol. In control group, commonly used procedure in PUMCH was performed with 0.45% chlorhexidine acetate plus 0.2% iodine. Blood culture positive results for 4 target organisms (Coagulase-negative staphylococci, Propionibacterium acnes, Corynebacterium species and Bacillus species) were further assessed by physicians from infectious department to determine whether a sample was true positive (pathogen) or false positive (contamination).
Results:
Total 9321 blood culture collections were analyzed. The blood culture contamination rate in test group was significantly lower than that in control group (5/3177 (0.16%) vs. 77/6144 (1.25%); χ(2) = 13.382, P < 0.001). The most common contaminant was Coagulase-negative staphylococcus (76.83%). The average cultural time during which contaminated samples became positive was longer than that for true pathogen samples (42.0 hours vs. 13.9 hours, P = 0.041).
Conclusion:
Using a strict blood collection procedure can significantly reduce blood culture contamination rate.
Insights
Implementing a strict blood collection protocol significantly reduces blood culture contamination rates. This method, using specific disinfectants, proved more effective than standard procedures in a hospital setting.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Patient Safety
Background:
- Blood culture contamination is a frequent adverse event in healthcare.
- Contaminated samples can lead to misdiagnosis and inappropriate treatment.
- Reducing contamination is crucial for accurate microbiological diagnostics.
Purpose of the Study:
- To evaluate the effectiveness of a strict blood collection procedure.
- To compare contamination rates between a new protocol and a standard procedure.
- To identify strategies for improving blood culture accuracy.
Main Methods:
- A prospectively controlled study was conducted over 16 months.
- A strict protocol involving trained nurses and specific disinfection (2.5% tincture of iodine plus 70% alcohol) was used in the test group.
- A control group used the standard disinfection procedure (0.45% chlorhexidine acetate plus 0.2% iodine).
Main Results:
- The contamination rate in the strict protocol group was significantly lower (0.16%) compared to the control group (1.25%).
- Coagulase-negative staphylococcus was the most common contaminant (76.83%).
- Contaminated samples took longer to show positive results (42.0 hours) than true pathogen samples (13.9 hours).
Conclusions:
- A strict blood collection procedure demonstrably reduces blood culture contamination.
- The findings support the adoption of enhanced protocols to improve diagnostic accuracy.
- Optimized disinfection and standardized procedures are key to minimizing false positives in blood cultures.
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