Revisiting factors associated with blood culture positivity: Critical factors after the introduction of automated continuous monitoring blood culture systems

Abstract

Blood culture is the main tool used to identify causative pathogens. Adequate volume and number of culture sets are considered key to blood culture positivity rate. It is not known whether these factors remain critical to the positivity rate after the introduction of automated continuous blood culture system monitoring.We measured blood volume per bottle and described the distribution of blood volume and number of culture sets. Multivariate logistic regression was performed to determine the independent association of blood volume, number of culture sets, diagnosis of sepsis in a patient, and other covariates with blood culture results.Only 6.9% of the blood culture bottle volumes complied with the guidance (8-10 mL), with the highest culture positivity rate (18%). Of the culture events, only one set of blood was cultured in 60.9% of events. In the multivariate analysis, blood culture volume per event (odds ratio [OR], 1.09 [95% confidence interval [CI], 1.06-1.11]), patients with a diagnosis of sepsis (OR, 2.86 [95% CI, 2.06-3.98]), and samples from the emergency department (OR, 2.29 [95% CI, 1.72-3.04]), but not the number of culture sets (OR, 0.74 [95% CI, 0.50-1.12]), were observed to be statistically significant with respect to blood culture positivity rate.Our results revealed that the total blood culture volume and the diagnosis of sepsis were critical factors affecting blood culture positivity rate. However, the proportion of blood culture bottles with the optimal blood volume was very low, and optimizing blood volume would be key to increasing blood culture positivity rate.

Are multiple blood cultures advantageous for canine patients?

“…17 Investigations that had evaluated multiple human blood samples taken within a 24-h period found that the detection rate increased from 65.1–73.1% for the first blood samples to 80.4–89.7% and 95.7–98.2% for 2 and 3 blood cultures, respectively. 3,12,13 Our detection rate for 2 blood cultures was only 9.1%, which could be explained by a limited sample size ( n = 11), and 36.2% for 3 blood cultures ( n = 47). Although collecting multiple blood samples at 30–60-min intervals has been common practice, studies have demonstrated that multiple samples drawn (almost) simultaneously had similar detection rates, 2 which has been explained by a cumulatively higher amount of blood cultured per human patient.…”

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