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Published on: October 15, 2014
Impact of Contaminated Blood Cultures on Children, Families, and the Health Care System
Megan Farrell1, Sarah Bram1, Hongjie Gu2
1Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, Missouri.
Insights
Contaminated blood cultures significantly increase hospital readmissions, testing, and costs for patients and the healthcare system. This burden highlights the need for improved blood culture practices.
Area of Science:
- Clinical Microbiology
- Healthcare Management
- Patient Safety
Background:
- Contaminated blood cultures represent a substantial challenge in healthcare.
- The financial and clinical impact on patients and healthcare systems requires thorough investigation.
Purpose of the Study:
- To assess the consequences of contaminated peripheral blood cultures on patient outcomes and healthcare resource utilization.
- To compare the hospital course, readmission rates, and associated costs between patients with contaminated and negative blood cultures.
Main Methods:
- A retrospective case-control study was conducted between January 1, 2014, and December 31, 2017.
- Patients with contaminated blood cultures were compared to those with negative cultures, stratified into emergency department (ED) and inpatient groups.
- Outcomes analyzed included hospital course, return visits, charges, and length of stay.
Main Results:
- Discharged ED patients with contaminated cultures had a 55% return rate versus 4% for controls, with significant increases in repeat testing, consultations, and antibiotic use.
- ED patients with contaminated cultures incurred an average of $4660 in additional charges per revisit.
- Inpatients with contaminated cultures showed increased repeat blood cultures, consultations, broader antibiotic coverage, longer length of stay, and higher laboratory charges.
Conclusions:
- Contaminated blood cultures lead to significant increases in hospital readmissions.
- These contaminations also drive higher rates of diagnostic testing and procedures.
- The overall impact includes extended length of stay and elevated hospital charges, particularly affecting pediatric populations.
Background:
Contaminated blood cultures pose a significant burden. We sought to determine the impact of contaminated peripheral blood cultures on patients, families, and the health care system.
Methods:
In this retrospective case-control study from January 1, 2014, to December 31, 2017, we compared the hospital course, return visits and/or admissions, charges, and length of stay of patients with contaminated peripheral blood cultures (case patients) with those of patients with negative cultures (controls). Patients were categorized into those evaluated and discharged from the emergency department (ED) (ED patients) and those who were hospitalized (inpatients).
Results:
A total of 104 ED case patients were matched with 208 ED control patients. A total of 343 case inpatients were matched with 686 inpatient controls. There was no significant difference between case and control patient demographics, ED, or hospital course at presentation. Fifty-five percent of discharged ED patients returned to the hospital for evaluation and/or admission versus 4% of controls. There was a significant (P < .0001) increase in repeat blood cultures (43% vs 1%), consultations obtained (21% vs 2%), cerebrospinal fluid studies (10% vs 0%), and antibiotic administration (27% vs 1%) in ED patients compared with controls. Each ED patient requiring revisit to the hospital incurred, on average, $4660 in additional charges. There was a significant (P < .04) increase in repeat blood cultures (57% vs 7%), consultations obtained (35% vs 28%), broadening of antibiotic coverage (18% vs 11%), median length of stay (75 vs 64 hours), and median laboratory charges ($3723 vs $3296) in case inpatients compared with controls.
Conclusions:
Contaminated blood cultures result in increased readmissions, testing and/or procedures, length of stay, and hospital charges in children.
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