Effectiveness of a blood culture bundle in reducing contamination rates in a neonatal intensive care unit

Isolating microorganisms from blood cultures is the gold standard for identifying the cause of sepsis. However, contamination of the blood culture is a significant barrier to the blood culture's utility. In this study, we aimed to evaluate the impact of blood culture bundles on the incidence of contamination in the neonatal intensive care unit (NICU).

A prospective research to compare pre-bundle and bundle periods was created. During the bundle period, a bundle for blood culture sampling was implemented. The numbers of unnecessary antibiotic days and hospital stay following a false positive blood culture were used to calculate costs.

A total of 320 neonatal blood culture procedures were included. The rate of blood culture contamination was 3.8% in the bundle and 12.5% in the pre-bundle period, this was significantly higher in the pre-bundle period (p<0.001). The implementation of the blood culture bundle reduced blood culture contamination by 69.6%. The average number of hospital days attributed to blood culture contamination was 3.8 days. The average cost of a hospital stay due to contamination of one blood culture was $883.12. During the study, 14 blood culture contaminations, 54 unnecessary NICU stay days were avoided and $12549.6 were saved.

We found that the blood culture bundle program was successful at decreasing the blood culture contamination, preventing additional hospital stay and treatment costs in the NICU.