2019
DOI: 10.1017/ice.2019.37
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Drawing blood cultures through intravascular catheters: Controversy and update

Abstract: Studies published between 1999 and 2011 demonstrated increased blood culture contamination with catheter-drawn cultures compared with percutaneously-drawn cultures. Studies published between 2012 and 2015 reported that use of antiseptic barrier caps on central venous catheter hubs significantly reduces the incidence of catheter-drawn blood culture contamination. Local guidelines regarding sites for blood culture collection should reflect institution-level blood culture contamination rates for percutaneously-dr… Show more

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Cited by 8 publications
(5 citation statements)
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“…rates. 16 Therefore, drawing blood peripherally is preferable to drawing it from a central line. 17 The performance improvement committee collaborated with the hospital's infection prevention team and cardiac clinical nurse specialist to develop a blood culture algorithm (see Figure 1) and CLABSI prevention tip sheet.…”
Section: Methodsmentioning
confidence: 99%
See 1 more Smart Citation
“…rates. 16 Therefore, drawing blood peripherally is preferable to drawing it from a central line. 17 The performance improvement committee collaborated with the hospital's infection prevention team and cardiac clinical nurse specialist to develop a blood culture algorithm (see Figure 1) and CLABSI prevention tip sheet.…”
Section: Methodsmentioning
confidence: 99%
“…The committee decided to go beyond the central line bundle and incorporate evidence-based blood culture practices into the QI initiative. This decision was based on the latest evidence showing that biofilm accumulation in the central line may lead to false-positive blood test results that falsely increase CLABSI rates 16. Therefore, drawing blood peripherally is preferable to drawing it from a central line 17…”
Section: Methodsmentioning
confidence: 99%
“…The motivation behind this change in practice reflects the fact that central line-associated bloodstream infections are associated with potential loss of hospital reimbursement from the Centers for Medicare & Medicaid Services and third-party payers, as well as potential damage to institutional reputation. However, this practice is based on older studies [ 1 , 2 ] before the increasing use of port protectors [ 3 , 4 ] and conflicts with Infectious Diseases Society of America guidelines [ 5 , 6 ]. Additionally, how can a clinician definitively diagnose a catheter-related bloodstream infection (CRBSI) if only percutaneously drawn cultures are obtained unless the patient has purulent drainage from the insertion site (uncommon in patients with infected CVCs; more common with infected short-term peripheral venous catheters), or the catheter is removed and the tip is cultured revealing the same microbe as in the blood?…”
Section: Main Pointmentioning
confidence: 99%
“…Better means to detect CVC colonization and CRBSI while the CVC is in situ would be very helpful. Last, studies are needed comparing blood culture contamination using a blood culture diversion device [ 17 ] for percutaneously drawn cultures and blood culture contamination when drawn through a central venous catheter hub after removal of a needleless connector and antiseptic barrier cap [ 3 ].…”
Section: Recommendationsmentioning
confidence: 99%
“…Contaminated blood cultures can be clinically confusing, potentially leading to overuse of antibiotics and drawing healthcare teams' attention away from actual causes of fever in patients in the ICU. Strategies to reduce the higher contamination rates from catheter blood cultures include use of antiseptic barrier caps on central venous catheter hubs and only obtaining cultures after the removal of the old needleless connector or through a new connector (52). Differential time to positivity (TTP) can be used to define catheter-associated bacteremia.…”
Section: Rationalementioning
confidence: 99%