A simplified blood culture sampling protocol for reducing contamination and costs: a randomized controlled trial

Area of Science:

• Clinical Microbiology
• Infectious Diseases
• Patient Safety

Background:

• Blood culture contamination poses risks including unnecessary antibiotic use and increased healthcare costs.
• Initial blood specimen diversion is an effective strategy to reduce contamination rates.
• The study investigated if a simplified diversion technique could achieve similar results without specialized devices.

Purpose of the Study:

• To evaluate the efficacy of an initial specimen diversion technique (ISDT) in reducing blood culture contamination rates.
• To determine if ISDT could be implemented without dedicated devices or procedural changes.
• To assess the economic impact of ISDT implementation.

Main Methods:

• A randomized controlled trial was conducted from September 2017 to September 2018.
• The study compared a standard blood collection method with an ISDT using regular vacuum tubes.
• Adult patients requiring blood cultures and chemistry tests were included; economic benefits were also assessed.

Main Results:

• The ISDT reduced blood culture contamination by 66% (from 5% to 1.6%) compared to the standard method.
• This reduction was achieved without compromising the detection of true bloodstream infections.
• Hospital-wide ISDT implementation resulted in a 1.1% saving in hospitalization days and no additional costs.

Conclusions:

• A simple initial specimen diversion technique effectively reduces blood culture contamination.
• This cost-effective approach enhances patient safety by minimizing risks associated with contaminated cultures.
• The findings support the adoption of ISDT as a practical measure in clinical settings.