January 19, 2023
2 minutes to read
Blood culture contamination was significantly reduced when phlebotomy scientists used a primary sample diverter device on patients versus using traditional venipuncture, according to a recent study.
“This study was motivated by the fact that many of our patients who had central line associated bloodstream infections (CLABSIs) appeared to have contaminated blood cultures, as defined in the article,” Lucy S. Tompkins, MD, PhDMD, a hospital epidemiologist and medical director of the Division of Infection Prevention and Control at Stanford Hospital, told Helio.
“I was also aware that patients with contaminated blood cultures may receive excess antibiotics, which are associated with other downstream complications, such as: Clostridium difficile “Infection, decreased kidney function, additional infections, longer stays, etc,” Tompkins said.
For this reason, Tompkins and colleagues tested an initial sample conversion device (ISDD) called Steripath on inpatients and hospitalized ED patients – including a large number of patients in intensive care units where blood culture contamination (BCC) appears to occur frequently – to assess the effect of the device on inpatients and ED BCC, CLABSI and ratios Standard infections (SIRs) and administration of antibiotics.
According to the study, phlebotomists used traditional venipuncture with or without ISDD, while registered nurses (RNs) used traditional venipuncture. BCC events were observed and compared between the two groups between March 17, 2019, and January 21, 2020.
Overall, 24% of the blood cultures taken were from patients in the intensive care unit. Phlebotomy using conventional venipuncture (n = 4,759) had a BCC rate of 2.3%, whereas phlebotomy using ISDD (n = 11,202) had a rate of 0% BCC. RNs, who drew a total of 7,411 blood cultures, had a 0.8% BCC rate.
According to the study, the CLABSI SIR decreased from 1.103 in 2017 and 0.658 in 2018 to 0.439 in 2019.
Based on these findings, the authors write that “it is possible to eliminate BCC” and “get to zero” when ISDD is used successfully, in line with a recently updated Clinical and Laboratory Standards Institute recommendation, to reduce BCC to less than a 1% rate.
Lucy S. Tompkins, MP, Ph.D
“Devices such as the Steripath that trap primary blood containing contaminated bacteria from the skin and subcutaneously in a separate chamber can reduce blood culture contamination rates to very low or even non-existent levels,” Tompkins said.
“Furthermore it, Minimize blood culture contamination CLABSI can lead to decreased SIRs. It is a very important measure of quality. She said avoiding blood culture contamination is a critically important effort for patient safety and quality.