Contaminants in blood cultures: importance, implications, interpretation and prevention

Dargère, S.; Cormier, H.; Verdon, Renaud

doi:10.1016/j.cmi.2018.03.030

Cited by 136 publications

(120 citation statements)

References 76 publications

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“…Bacteremia episodes were segregated into contaminants and BSI. Coagulase-negative staphylococci (CoNS), coryneform bacteria, non-pneumococcal viridans streptococci, Propionibacterium, Bacillus and Micrococcus species, were considered contaminants when yielded from a unique BC but were considered BSI when yielded from multiples BC and considered clinically significant [8]. Other organisms, such as Enterobacteriaceae, Staphylococcus aureus or Pseudomonas aeruginosa, were defined as pathogens and did require only a single positive BC to be considered as responsible for a BSI [9].…”

Section: Methodsmentioning

confidence: 99%

Utility of anaerobic bottles for the diagnosis of bloodstream infections

et al. 2020

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Background: Obligate anaerobes usually account for less than 10% of bacteria recovered from blood cultures (BC). The relevance of routine use of the anaerobic bottle is under debate. The aim of this study was to evaluate the utility of anaerobic bottles for the diagnosis of bloodstream infections (BSI). Methods: We conducted a 6-month, retrospective, monocentric study in a tertiary hospital. All positive BC were grouped into a single episode of bacteremia when drawn within 7 consecutive days. Bacteremia were classified into contaminants and BSI. Charts of patients with BSI due to obligate anaerobes were studied. Results: A total of 19,739 blood cultures were collected, 2341 of which (11.9%) were positive. Anaerobic bottles were positive in 1528 (65.3%) of all positive BC but were positive alone (aerobic bottles negative) in 369 (15.8%). Overall 1081 episodes of bacteremia were identified, of which 209 (19.3%) had positive anaerobic bottles alone. The majority 126/209 (60.3%) were contaminants and 83 (39.7%) were BSI. BSI due to facultative anaerobes, obligate aerobes and obligate anaerobes were identified in 67 (80.7%), 3 (3.6%) and 13 (15.7%) of these 83 episodes, respectively. BSI due to obligate anaerobic bacteria were reported in 9 patients with gastro-intestinal disease, in 3 with febrile neutropenia and in 1 burned patient. Conclusions: Anaerobic bottles contributed to the diagnosis of a significant number of episodes of bacteremia. Isolated bacteria were mostly contaminants and non-obligate anaerobic pathogens. Rare BSI due to obligate anaerobes were reported mainly in patients with gastro-intestinal disorders and during febrile neutropenia.

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Section: Methodsmentioning

confidence: 99%

Utility of anaerobic bottles for the diagnosis of bloodstream infections

et al. 2020

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“…Currently, blood cultures (BC) are still the gold standard for diagnosing and managing bloodstream infections, which can result in increased morbimortality (1) . However, BC contamination can cause errors in clinical decisions in infectious processes, negatively impacting patients, translating into longer hospital stays, retests, and even the use of inappropriate/unnecessary antibiotics, increasing hospital costs and reducing quality of care (2) .…”

Section: Introductionmentioning

confidence: 99%

“…Studies have suggested that BC contamination occurs before samples reach the laboratory, during their extraction and manipulation (1,3) .…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, different authors state that heightened workloads and frequent turnover produce increased BC contamination (1) . These situations are common in intensive care units (ICUs), emergency services, as well as in internal medicine units (8) , with the latter receiving little attention in terms of implementing educational actions to reduce the incidence of contaminated BC.…”

Section: Introductionmentioning

confidence: 99%

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Efectividad de un programa de formación online en una unidad de enfermería: extracción de hemocultivos

Zaragoza-García

Pérez-García

Orellana

et al. 2019

Rev. esc. enferm. USP

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RESUMEN Objetivo: Evaluar la eficacia de una plataforma formativa en línea de procedimientos en una planta de medicina interna para disminuir los hemocultivos contaminados. Método: Estudio cuasi-experimental con grupos paralelos. La muestra la componen enfermeras de medicina interna de un hospital terciario, con las que se lleva a cabo un programa de formación en línea en relación a la técnica extracción de hemocultivos. Se evalúan conocimientos pre y post intervención sobre la técnica. Además, se estudian los resultados de los hemocultivos 6 meses antes y 3 después de la intervención, analizando los contaminados. Resultados: Participan un total de 48 enfermeras. El conocimiento de la técnica antes de la intervención es homogéneo en ambos grupos, mejorando significativamente con la formación en línea (p=0.0001). El análisis de hemocultivos extraídos previos a la formación muestran niveles de contaminación por encima del estándar internacional, disminuyendo en el grupo intervención hasta el 3% después del programa de aprendizaje. Conclusión: La intervención educativa mediante una plataforma digital se muestra válida para la adquisición de conocimientos y su translación a la práctica clínica.

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“…The situation is disappointing: the sampling of BCs is often poor (too small volume of blood obtained), which impacts the detection rate. The results are further affected by skin contaminants, which affect interpretation of the BC results [6e9], as presented in this issue [10]. In addition, reporting of results often takes too long in a situation where a timely diagnosis is crucial.…”

mentioning

confidence: 99%