Updated Review of Blood Culture Contamination

Abstract

SUMMARY Blood culture contamination represents an ongoing source of frustration for clinicians and microbiologists alike. Ambiguous culture results often lead to diagnostic uncertainty in clinical management and are associated with increased health care costs due to unnecessary treatment and testing. A variety of strategies have been investigated and employed to decrease contamination rates. In addition, numerous approaches to increase our ability to distinguish between clinically significant bacteremia and contamination have been explored. In recent years, there has been an increase in the application of computer-based tools to support infection control activities as well as provide clinical decision support related to the management of infectious diseases. Finally, new approaches for estimating bacteremia risk which have the potential to decrease unnecessary blood culture utilization have been developed and evaluated. In this review, we provide an overview of blood culture contamination and describe the potential utility of a variety of approaches to improve both detection and prevention. While it is clear that progress is being made, fundamental challenges remain.

Microbiological Profile and Antibiogram of Blood Stream Isolates at a Referral Hospital in North Delhi: A One Year Study

“…The overall contamination rate in our blood cultures was 5.8%, which is higher than the published benchmark standards [28]. Contamination rate reported by other authors was 12.6%by Chraiti et al [29] and 18% by Malik et al [30].…”

“…The tracking and reporting of blood stream infection rates are both important activities that rely heavily on the accurate differentiation of contamination from true bacteremia. [28] …”

Predicting bacteremia based on nurse‐assessed food consumption at the time of blood culture

“…If only 1 set of blood cultures was acquired and was positive for a pathogenic organism (such as enteric Gram-negative bacilli or Streptococcus pneumonia) that could account for the clinical presentation, then the culture was considered positive. 7,14,15 Definition of Contamination We considered as contaminants organisms common to skin flora, including Bacillus species, coagulase-negative staphylococci, Corynebacterium species, and Micrococcus species, without isolation of an identical organism with the same antibiotic susceptibilities from another potentially infected site in a patient with incompatible clinical features and no attributable risks. 16 Single blood cultures positive for organisms thought unlikely to explain the patient's symptoms were also considered contaminants.…”

Epidemiological Evaluation of Blood Culture Patterns among Neonates Receiving Vancomycin

“…BC remains the current gold standard for the diagnosis of bacteremia [12,13] and is recommended to serve as the basis for the transition from empiric treatment to continued course of therapy and may be used to guide rational antibiotic selection [14]. Nonetheless, BC is limited by its low sensitivity and the time required to grow fastidious organisms.…”