Reducing blood-culture contamination rates by the use of a 2% chlorhexidine solution applicator in acute admission units

Madeo, Maurice; Barlow, Gavin

doi:10.1016/j.jhin.2008.03.009

Cited by 20 publications

(14 citation statements)

References 4 publications

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“…92 Table 2 updates BCC outcomes as initially compiled by Trautner et al in 2002 68 and includes several additional trials. 70,[93][94][95][96][97][98][99][100][101][102][103] The most widely studied alcoholic CHG concentration is 2%, with most findings below the desirable BCC rate of 3%. Despite several limitations of the cited studies (eg, variations in the definition of contamination and personnel drawing BCs, potential confounding effect of multiple interventions, lack of compliance monitoring to established protocols), it would appear that solutions combining IPA and CHG are superior products in health care for many patient populations in a wide variety of settings, 50,104 providing effective bacterial kill and a rapid drying time of 30 seconds.…”

Section: Antisepsis Of Skinmentioning

confidence: 99%

Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central line–associated bloodstream infections

Garcia

Spitzer

Beaudry

et al. 2015

American Journal of Infection Control

118

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Section: Antisepsis Of Skinmentioning

confidence: 99%

Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central line–associated bloodstream infections

Garcia

Spitzer

Beaudry

et al. 2015

American Journal of Infection Control

118

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“…Many studies advocate the effectiveness of teams of specialized phlebotomists in reducing contamination rates (5,18,21). Feedback, intense education in correct phlebotomy routines, and long-term monitoring programs have also been shown to be effective (3,4,6,10). In general, interventions seem less effective and contamination rates higher among nursing personnel conducting phlebotomy than those for specialized phlebotomy teams (5,6,15,18,21).…”

mentioning

confidence: 99%

Reducing Blood Culture Contamination by a Simple Informational Intervention

et al. 2010

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Compared to truly negative cultures, false-positive blood cultures not only increase laboratory work but also prolong lengths of patient stay and use of broad-spectrum antibiotics, both of which are likely to increase antibiotic resistance and patient morbidity. The increased patient suffering and surplus costs caused by blood culture contamination motivate substantial measures to decrease the rate of contamination, including the use of dedicated phlebotomy teams. The present study evaluated the effect of a simple informational intervention aimed at reducing blood culture contamination at Skåne University Hospital (SUS), Malmö, Sweden, during 3.5 months, focusing on departments collecting many blood cultures. The main examined outcomes of the study were pre-and postintervention contamination rates, analyzed with a multivariate logistic regression model adjusting for relevant determinants of contamination. A total of 51,264 blood culture sets were drawn from 14,826 patients during the study period (January 2006 to December 2009). The blood culture contamination rate preintervention was 2.59% and decreased to 2.23% postintervention (odds ratio, 0.86; 95% confidence interval, 0.76 to 0.98). A similar decrease in relevant bacterial isolates was not found postintervention. Contamination rates at three auxiliary hospitals did not decrease during the same period. The effect of the intervention on phlebotomists' knowledge of blood culture routines was also evaluated, with a clear increase in level of knowledge among interviewed phlebotomists postintervention. The present study shows that a relatively simple informational intervention can have significant effects on the level of contaminated blood cultures, even in a setting with low rates of contamination where nurses and auxiliary nurses conduct phlebotomies.Blood cultures are commonly contaminated, with contaminated cultures representing as many as 50% of positive cultures (1). Compared to truly negative cultures, false-positive (contaminated) blood cultures not only increase laboratory work but also prolong lengths of patient stay and increase the use of broad-spectrum antibiotics, with negative consequences for antibiotic resistance and patient morbidity. Furthermore, false-positive results can cause confusion regarding antibiotic regimens, endangering patient safety (2, 5, 16).The dominating organism in blood culture contamination, coagulase-negative staphylococcus (CoNS), is also an increasingly important pathogen, which is a significant clinical problem because there is no true "gold standard" for determining contamination from relevant pathogens (1, 8, 13, 22). Although not applicable for clinical use for individual patients, a laboratory assessment definition of contamination for comparison of rates between institutions has been developed. Target rates should not exceed 3% (7), but many teaching hospitals have contamination rates exceeding 6% or more (2,17,21).Considering the potential savings in resource utilization, it is justified to invest considerable reso...

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“…result was anticipated as most studies have proven on its practicality due to its property that dries quickly and effectiveness in lowering the contamination rate. [5][6] Besides differentiating the effect of two types of skin antiseptic, this study aimed to ensure a good practice in blood culture taking, by a comprehensive approaches to improved understanding, knowledge and awareness on blood culture technique. thus, we had decided that by providing educational input in the remedial measures the associated factors in lowering the contamination rates can be strengthened.…”

Section: Discussionmentioning

confidence: 99%

Reducing blood culture contamination rate: A quality assurance project in a Malaysian tertiary hospital

Ramli¹,

Zahari²,

Sadri³

et al. 2014

Int. j. infect. control

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Blood cultures contamination is a common scenario in Malaysian hospitals. Reducing the contamination rate of blood culture will reduce false-positive blood culture, prevent inappropriate antibiotic prescription and reduce patient management cost. This is a 6 months study specifically focused on the effects of changing the type of skin antiseptics used (70% isopropyl alcohol plus 2% chlorhexidine replacing 70% isopropyl alcohol plus povidone-iodine) and improving the knowledge and techniques of blood culture taking in a tertiary hospital. the remedial measures introduced were successful in achieving 4.34% contamination rate, which is 2.03% less than pre-remedial contamination rate (6.37%). There was a statistically significant reduction in the number of contaminants (p = 0.02) with five-fold rise in the significant blood cultures results. Better choice of skin antiseptics and good blood culture knowledge and technique may contribute to reduce number of contamination rate in blood culture.

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Reducing blood-culture contamination rates by the use of a 2% chlorhexidine solution applicator in acute admission units

Cited by 20 publications

References 4 publications

Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central line–associated bloodstream infections

Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central line–associated bloodstream infections

Reducing Blood Culture Contamination by a Simple Informational Intervention

Reducing blood culture contamination rate: A quality assurance project in a Malaysian tertiary hospital

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