Blood culture contamination in hospitalized pediatric patients: a single institution experience

Abstract

PurposeBlood culture is the most important tool for detecting bacteremia in children with fever. However, blood culture contamination rates range from 0.6% to 6.0% in adults; rates for young children have been considered higher than these, although data are limited, especially in Korea. This study determined the contamination rate and risk factors in pediatric patients visiting the emergency room (ER) or being admitted to the ward.MethodsWe conducted a retrospective chart review of blood cultures obtained from children who visited Yonsei Severance Hospital, Korea between 2006 and 2010. Positive blood cultures were labeled as true bacteremia or contamination according to Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for laboratory-confirmed bloodstream infection, after exclusion of cultures drawn from preexisting central lines only.ResultsAmong 40,542 blood cultures, 610 were positive, of which 479 were contaminations and 131 were true bacteremia (overall contamination rate, 1.18%). The contamination rate in the ER was significantly higher than in the ward (1.32% vs. 0.66%, P<0.001). The rate was higher in younger children (2.07%, 0.94%, and 0.61% in children aged <1 year, 1-6 years, and >6 years, respectively).ConclusionOverall, contamination rates were higher in younger children than in older children, given the difficulty of performing blood sampling in younger children. The contamination rates from the ER were higher than those from the ward, not accounted for only by overcrowding and lack of experience among personnel collecting samples. Further study to investigate other factors affecting contamination should be required.

Skin preparation for prevention of peripheral blood culture contamination in children

“…(80.8%, 413/511) and Norberg et al . (85%, 191/223) . With the wider access to pneumococcal conjugate vaccine in children aged <5 years and Hib vaccine, it is likely that in the present cohort the rate of positive blood cultures was also decreased in the 2015–2017 period, as well as the rate of positive S. pneumoniae and Hib isolations.…”

“…Electronic medical records were retrospectively reviewed for blood culture results obtained from patients aged 0–6 years visiting the ED or admitted to the hospital. We focused on subjects from infant to preschool age, who were more likely to have higher contamination rates . Patients with an indwelling central venous catheter at the time of blood culture collection were excluded.…”

“…We focused on subjects from infant to preschool age, who were more likely to have higher contamination rates. 3,8 Patients with an indwelling central venous catheter at the time of blood culture collection were excluded. Medical records were reviewed in order to obtain pertinent demographic data, clinical and laboratory information, and types of bacteria isolated.…”

“…Therefore, obtaining sterile blood cultures is crucial. The Clinical and Laboratory Standards Institute (CLSI) recommends a contamination rate of up to 3%; general published rates are 0.6–6%, and in pediatric emergency departments, 1.32–11% . One of the factors affecting the contamination rate is skin preparation as part of the venipuncture protocol .…”

“…The Clinical and Laboratory Standards Institute (CLSI) recommends a contamination rate of up to 3%; general published rates are 0.6-6%, 6,7 and in pediatric emergency departments, 1.32-11%. 1,3 One of the factors affecting the contamination rate is skin preparation as part of the venipuncture protocol. 5 Younger patient age and the level of experience of those obtaining the culture were other factors associated with culture contamination.…”