Estimated Clinical and Economic Impact through Use of a Novel Blood Collection Device To Reduce Blood Culture Contamination in the Emergency Department: a Cost-Benefit Analysis

Skoglund, Erik; Dempsey, Casey J; Chen, Hua; Garey, Kevin W.

doi:10.1128/jcm.01015-18

Cited by 31 publications

(33 citation statements)

References 34 publications

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“…The costs associated with performing blood cultures were $36 per blood culture set and $104 for microorganism ID and AST (42). The estimated cost of REBA Sepsis-ID is $41 per sample, as referred to the cost of other line probe assay used in clinical microbiology laboratory such as the Genotype MTBDR assay (Hain Lifescience, Nehren, Germany) (43).…”

Section: Discussionmentioning

confidence: 99%

Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels

Kim

et al. 2020

Front. Med.

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Sepsis is one of the medical emergencies, and its early detection, within the first hours of development, and proper management improve outcomes. Molecular diagnostic assays using whole blood collected from patients with suspected sepsis have been developed, but the decision making is difficult because of the possibility of false positives, due to contamination. Here, we evaluated the performance of the reverse blot hybridization assay (REBA) Sepsis-ID test for the detection of sepsis-causing microorganisms using whole-blood samples. In addition, the concentrations of Creactive protein (CRP) and procalcitonin (PCT) were determined to evaluate whether these biomarkers can provide criteria for performing REBA Sepsis-ID in clinical settings. For this study, EDTA-anticoagulated whole blood was simultaneously collected for REBA Sepsis-ID and blood culture from 440 patients with suspected sepsis, from January to October 2015. In addition, CRP and PCT concentrations were measured in 227 patients. The overall positive rates of REBA Sepsis-ID and blood culture were 16.6% (73/440) and 13.9% (61/440), respectively. The pathogen-positive rates of REBA Sepsis-ID and blood culture were 9.8% (43/440) and 9.5% (42/440), respectively. The areas under the receiver operating characteristic (AUROC) curves of PCT and CRP for predicting pathogen-positive results of REBA Sepsis-ID were 0.72 and 0.69, respectively. The PCT concentrations in the group of patients aged ≥50 years were significantly higher than those in the group aged <50 years. After adjusting for age, the PCT AUROC value was 0.77 for predicting pathogen-positive results of REBA Sepsis-ID. The optimal cutoff values of PCT concentrations for subsequent application of REBA Sepsis-ID were 0.12 ng/mL in all patients and 0.22 ng/mL in patients aged ≥50 years. Our observations showed that REBA Sepsis-ID using whole blood was advantageous for the early detection of sepsis-causing microorganisms, and the PCT concentration could be used to determine the necessity of using REBA Sepsis-ID in clinical settings. The application of REBA Sepsis-ID using whole blood, based on the PCT concentration, may contribute to a highly efficient detection of sepsis-causing microorganisms.

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Section: Discussionmentioning

confidence: 99%

Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels

Kim

et al. 2020

Front. Med.

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“… 10 As noted, the use of commercial diversion devices reduced contamination rates, 11 which in models is projected to lead to considerable cost savings and reductions in patient length of stay. 13 , 14 In 2 recent studies, blood culture contamination was reduced without using expensive commercial diversion devices, by diverting a small amount of blood using vacutainer tubes by changing the test draw order, which could also be accomplished for blood cultures alone by simply discarding the diverted portion. 15 , 16 …”

Section: Preventing Contamination Of Blood Culturesmentioning

confidence: 99%

Modern Blood Culture

Gonzalez

Chao

Pettengill

2020

Clinics in Laboratory Medicine

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The optimal care of septic patients depends on the successful recovery of clinically relevant microorganisms from blood cultures and the timely reporting of organism identification and antimicrobial susceptibility testing (AST) results. Many preanalytic factors play a critical role in culturing microorganisms, and advancements in blood culture instrument technology have reduced the time to positive results. Additionally, rapid organism identification and AST results directly from positive blood culture broth via new methods help to further shorten the time from empiric to targeted treatment. This article summarizes the current state of blood culture methods, including preanalytic, analytical, and postanalytic factors that are available to clinical microbiology laboratories.

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“…4 Some of these studies were done before widespread use of needleless connectors on catheter hubs; none were conducted in the era of antiseptic barrier cap use 5 nor with technologies that divert an initial aliquot of blood. 6,7 A multimodal infection prevention program involved use of (1) a blood culture collection kit, (2) a 2-nurse protocol for blood culture collection, and/or (3) limiting catheter-drawn cultures (if such cultures were needed, the needleless connector was removed and the catheter hub was scrubbed before obtaining samples for blood cultures). 8 In the first 6 months of 2010 (baseline), 2011, and 2012, contamination rates of percutaneously-drawn blood cultures were 0.9% (40 of 4,353), 0.8% (39 of 4,733), and 0.5% (21 of 4,206), respectively.…”

Section: (Received 8 January 2019; Accepted 5 February 2019)mentioning

confidence: 99%

Drawing blood cultures through intravascular catheters: Controversy and update

Mermel

2019

Infect. Control Hosp. Epidemiol.

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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-drawn and catheter-drawn cultures using currently available technologies that reduce contamination at both sites.

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Estimated Clinical and Economic Impact through Use of a Novel Blood Collection Device To Reduce Blood Culture Contamination in the Emergency Department: a Cost-Benefit Analysis

Cited by 31 publications

References 34 publications

Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels

Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels

Modern Blood Culture

Drawing blood cultures through intravascular catheters: Controversy and update

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