Effectiveness of a Novel Specimen Collection System in Reducing Blood Culture Contamination Rates

Bell, Mary; Bogar, Catherine; Plante, Jean‐Sébastien; Rasmussen, Kristen; Winters, Sharon

doi:10.1016/j.jen.2018.03.007

Cited by 24 publications

(46 citation statements)

References 22 publications

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“…Currently, blood culture is still the criterion standard for the diagnosis of bacterial BSI. [5] However, blood culture requires a long time, and the sensitivity and positive rate are low, which does not allow early diagnosis of and clinical guidance for BSIs. In addition, although matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) has been initially used for the auxiliary diagnosis of pathogens in BSIs [6,7] and the reporting time of the results is earlier than that of blood culture, but MALDI-TOF-MS is based on blood culture method and so has certain limitations in the early diagnosis of pathogens in BSIs.…”

Section: Introductionmentioning

confidence: 99%

The clinical value of IL-3, IL-4, IL-12p70, IL17A, IFN-γ, MIP-1β, NLR, P-selectin, and TNF-α in differentiating bloodstream infections caused by gram-negative, gram-positive bacteria and fungi in hospitalized patients

Yuan

Wang

2019

Medicine

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Early differential diagnosis of bloodstream infections (BSIs) caused by different sources and species of bacteria in hospitalized patients is crucial for the timely targeted interventions including appropriate use of antibiotics. The aim of this study was to identify 9 biomarkers for the early differentiation of gram-negative-bloodstream infection (GN-BSI), gram-positive (GP)-BSI, and fungal-BSI.A prospective study was conducted for a total of 390 inpatients who underwent blood culture in the Chinese PLA General Hospital from September 2015 to March 2018. Patients with positive culture of a single pathogen were divided into GN-BSI, GP-BSI, and Fungal-BSI groups, and a culture-negative disease control group was also established. The serum levels of macrophage inflammatory protein 1β (MIP-1β), tumor necrosis factor α (TNF-α), interleukin (IL)-3, interferon (IFN)-γ, IL-17A, IL-4, IL-12p70, and P-selectin were detected and the NLR was calculated from routine blood test. Receiver-operating characteristic analysis was used to determine the efficacy of various indicators in the differential diagnosis of BSIs. Prediction and validation experiments on clinical patient samples (263 cases) were also performed.The level of IL-3 in the GP-BSI group was significantly higher than those in the other 3 groups. The level of IFN-γ in the fungal-BSI group was significantly higher than those in the other 3 groups. NLR, MIP-1β, TNF-α, IL-17A, and IL3 exhibited some efficacy when distinguishing between GN-BSI and GP-BSI and NLR had the largest area under curve (AUC) (0.728), followed by MIP-1β with an AUC of 0.679. IFN-γ and IL-3 exhibited some value in differential diagnosis between GN-BSI and Fungal-BSI. IL-3, MIP-1β, TNF-α, IFN-γ, NLR, IL-17A, and IL-4 exhibited some value in distinguishing fungal-BSI and GP-BSI, with IL-3 had the largest AUC (0.722), followed by MIP-1β with an AUC of 0.703.NLR and MIP-1β may be valuable in differentiating GN-BSI from GP-BSI in hospitalized patients. IFN-γ and IL-3 may be helpful in differential diagnosis GN-BSI and fungal-BSI. IL-3 and MIP-1β exhibited some diagnostic efficacy in distinguishing fungal-BSI and GP-BSI. Additionally, IL-3 with high serum level may be a marker for GP-BSI and IFN-γ with high serum level may be a valuable marker for the prediction of Fungal-BSI. The utility of these biomarkers to predict BSIs owing to different pathogens in hospitalized patients needs to be assessed in further studies.

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Section: Introductionmentioning

confidence: 99%

The clinical value of IL-3, IL-4, IL-12p70, IL17A, IFN-γ, MIP-1β, NLR, P-selectin, and TNF-α in differentiating bloodstream infections caused by gram-negative, gram-positive bacteria and fungi in hospitalized patients

Yuan

Wang

2019

Medicine

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“…However, blood cultures commonly become contaminated with environmental or skin-residing organisms. 1,2 Contaminated cultures can lead to misdiagnosis, increased length of stay (LOS) and hospital costs, and unnecessary testing and antibiotic use. [1][2][3] National contamination rate recommendations are set at less than 3% by the Clinical and Laboratory Standards Institute (CLSI).…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Contaminated cultures can lead to misdiagnosis, increased length of stay (LOS) and hospital costs, and unnecessary testing and antibiotic use. [1][2][3] National contamination rate recommendations are set at less than 3% by the Clinical and Laboratory Standards Institute (CLSI). 4 However, institutions across the U.S. have varying and often higher contamination rates ranging from 2 -10%.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an Initial Specimen Diversion Device (ISDD) on Rates of Blood Culture Contamination in the Emergency Department

Buzard

Evans²,

Schroeder³

2021

kjm

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Introduction: Blood cultures are the gold standard for identifying bloodstream infections. The Clinical and Laboratory Standards Institute recommends a blood culture contamination rate of <3%. Contamination can lead to misdiagnosis, increased length of stay and hospital costs, unnecessary testing and antibiotic use. These reasons led to the development of initial specimen diversion devices (ISDD). The purpose of this study is to evaluate the impact of an initial specimen diversion device on rates of blood culture contamination in the emergency department. Methods: This was a retrospective, multi-site study including patients who had blood cultures drawn in an emergency department. February 2018 to April 2018, when an ISDD was not utilized, was compared with June 2019 to August 2019, a period where an ISDD was being used. The primary outcome was total blood culture contamination. Secondary outcomes were total hospital cost, hospital and intensive care unit length of stay, vancomycin days of use, vancomycin serum concentrations obtained, and repeat blood cultures obtained. Results: A statistically significant difference was found in blood culture contamination rates in the Pre-ISDD group vs the ISDD group (7.47% vs 2.59%, p<0.001). None of the secondary endpoints showed a statistically significant difference. Conclusions: Implementation of an ISDD reduces blood culture contamination in a statistically significant manner. However, we were unable to capture any statistically significant differences in the secondary outcomes.

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“…O ver 2.6 million ED visits across the United States result in a primary diagnosis of urinary tract infection. 1 While much attention has been paid to reducing blood culture contamination rates in the emergency department, [2][3][4][5][6][7][8][9] a substantial gap remains in projects aimed at reducing contamination in clean-catch urine specimens obtained in the ED setting. Obtaining an adequate urine culture is clinically important to the care of several vulnerable patient groups, including patients with diabetes or compromised immune responses, those with high risk for subsequent urosepsis, previous antibiotic resistant infections, multiple antibiotic allergies and/or repeated infections, and older adults.…”

mentioning

confidence: 99%

Accidental and Unintentional Findings From the Midstream Clean-Catch Urine Contamination Study: Insights From Applying the Behavior Engineering Model

Castner¹

2019

Journal of Emergency Nursing

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Effectiveness of a Novel Specimen Collection System in Reducing Blood Culture Contamination Rates

Cited by 24 publications

References 22 publications

The clinical value of IL-3, IL-4, IL-12p70, IL17A, IFN-γ, MIP-1β, NLR, P-selectin, and TNF-α in differentiating bloodstream infections caused by gram-negative, gram-positive bacteria and fungi in hospitalized patients

The clinical value of IL-3, IL-4, IL-12p70, IL17A, IFN-γ, MIP-1β, NLR, P-selectin, and TNF-α in differentiating bloodstream infections caused by gram-negative, gram-positive bacteria and fungi in hospitalized patients

Evaluation of an Initial Specimen Diversion Device (ISDD) on Rates of Blood Culture Contamination in the Emergency Department

Accidental and Unintentional Findings From the Midstream Clean-Catch Urine Contamination Study: Insights From Applying the Behavior Engineering Model

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