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Reducing blood culture contamination using an initial specimen diversion device.

Frederic S Zimmerman1, Marc V Assous2, Shoshana Zevin3

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A new blood culture diversion device significantly reduced contamination rates in hospitalized patients. This innovation minimizes false positives without affecting true-positive results, potentially lowering costs and antibiotic use.

Keywords:
False positive cultureInpatientSubcutaneous colonization

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Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Healthcare Quality Improvement

Background:

  • Blood culture contamination leads to unnecessary antibiotic use and prolonged hospital stays.
  • Standard skin disinfection may not eliminate deep skin-surface bacteria, contributing to contamination.
  • Specimen diversion devices aim to mitigate contamination by removing initial blood draw potentially containing skin plug.

Purpose of the Study:

  • To evaluate the effectiveness of a specimen diversion device in reducing blood culture contamination.
  • To assess the impact of the diversion device on true-positive culture rates.
  • To determine the clinical utility of diversion devices in hospitalized patients.

Main Methods:

  • A prospective, controlled, pragmatic study design was employed.
  • Blood cultures were collected using either a diversion device or standard methods as a control.
  • The study compared contamination rates between the two collection methods.

Main Results:

  • A total of 671 blood cultures were analyzed.
  • Cultures obtained with the diversion device showed a significantly lower contamination rate (1.0%) compared to standard methods (5.2%, P < .008).
  • No significant difference was observed in the detection rate of true-positive cultures between the groups.

Conclusions:

  • The use of a specimen diversion device is associated with a significant reduction in blood culture contamination.
  • This intervention does not compromise the detection of true-positive infections.
  • Implementing diversion devices may lead to decreased healthcare costs, reduced antibiotic consumption, and shorter hospital stays.