Blood Cultures in the Critical Care Unit

Shafazand, Shirin; Weinacker, Ann

doi:10.1378/chest.122.5.1727

Cited by 119 publications

(93 citation statements)

References 73 publications

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“…B. während eines stationären Aufenthaltes sind nach Dekolonisierung tägliche Kontrollen sinnvoll [414]. Abgeleitet von Erfahrungen mit der Sensitivität von diagnostischen Kulturen [415][416][417] wurde vermutet, dass die Sensitivität von Kontrollabstrichen, die unter laufenden antibiotischen oder antiseptischen Dekolonisierungsmaßnahmen entnommen wurden, eingeschränkt ist. Studien, die einen solchen Zusammenhang belegen, sind jedoch nicht publiziert.…”

Section: üBerprüfung Des Erfolges Der Dekolonisierungunclassified

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Ruscher

2014

Bundesgesundheitsbl.

123

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Section: üBerprüfung Des Erfolges Der Dekolonisierungunclassified

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Ruscher

2014

Bundesgesundheitsbl.

123

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“…Several reasons that may explain a false negative result in a blood culture, including prior antibiotic treatment that the patient receives when the sample is taken, the time interval between sampling, skin disinfection methods used before the culture is drawn, volume of the sample drawn and laboratory methods.The need to improve the sensitivity of the test while avoiding false positive results is discussed in the literature in different contexts in the non-surgical patients-emergency departments (Shapiro et al, 2008), hospitalization wards (Coburn et al, 2012;David et al, 1990) and ICU (Shafazand and Weinacker, 2002).…”

Section: Discussionmentioning

confidence: 99%

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

Segal¹

2013

American Journal of Infectious Diseases

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During the first six months of operating a new Internal-medicine ward in a tertiary hospital, a prospective survey, tracking both patient and environment bacteriological samples taken, was conducted. The motive behind the study was to establish the pattern in which environmental colonization is transmitted to the hospitalized patients and vice versa, thus defining the nosocomial pathogens that are typical to the ward. That information can be used to guide empirical antibiotic treatment. Patient sampling was done on clinical grounds whereas environmental cultures were systematically acquired from different surfaces around the ward. 6-months' results analysis suggest that clinically guided culture rates were tightly associated with volume of patients admitted, with no such association demonstrated between volume of cultures taken and rate of positive results, except for urine cultures. Regarding environmental sampling, we demonstrated no benefit in taking empirical, surface samples for common nosocomial pathogens. Our findings could further improve future resources allocation with regard to infection control and clinical bacteriology routines in newly established internal medicine wards.

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“…Moreover, they remain the standard method for detecting bacteremia in the evaluation of sick patients (14). Unfortunately, blood culture contamination is a common occurrence and may lead to confusion regarding the significance of a positive blood culture.…”

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Effects of Volume and Site of Blood Draw on Blood Culture Results

Gonsalves

Cornish

Moore³

et al. 2009

J Clin Microbiol

100

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Blood culture contamination greatly affects clinical decisions. Hence, it is of interest to assess the influence of factors such as the volume of blood drawn and the site of blood draw on the rates of blood culture contamination. In a retrospective study, blood cultures from infants and children up to 18 years of age who had at least one positive blood culture during the year 2006 were analyzed for their volume of blood drawn, patient's weight, site of blood draw used, and blood culture results. Blood cultures were deemed adequate collections if they contained an appropriate weight-related volume of blood. Moreover, blood culture results were categorized as true pathogens, contaminants, and negative cultures; these were then compared and analyzed with respect to their volume and site of blood draw. A total of 5,023 blood cultures were collected during 2006, of which 843 were analyzed. There were 306 (36%) positive cultures among the 843 cultures analyzed. Of the 306 positive cultures, 98 (32%) were contaminants and 208 (68%) cultures grew significant pathogens. Thirty-five percent of the contaminant cultures had adequate volume compared to 60% in the true bacteremia group (P < 0.001). Also, of the 843 cultures, the rates of contamination among the different sites of blood draw were as follows: peripheral venipuncture, 36%; arterial, 10%; and central venous access, 7% (P ‫؍‬ 0.155). The rate of contamination was higher with lower blood volumes, and there was no significant difference in the rates of contamination among the different sites of blood draw.Blood cultures are vital for identifying pathogens causing serious infections and in directing appropriate antibiotic therapy. Moreover, they remain the standard method for detecting bacteremia in the evaluation of sick patients (14). Unfortunately, blood culture contamination is a common occurrence and may lead to confusion regarding the significance of a positive blood culture. The most common contaminants are coagulase-negative staphylococcus species which are also becoming more prevalent as a primary pathogen in immunocompromised patients and in patients with indwelling intravascular devices (9, 15). The uncertain clinical significance of potential contaminants leads to longer hospital stays, unnecessary antibiotic therapy, and additional laboratory testing; as a result, the cost incurred by a hospital is many times that incurred by the laboratory (2).Many factors influence the yield of blood cultures, but the single most important factor is blood volume. Several studies have shown that the rate of isolation of pathogens from blood cultures increases with the quantity of blood submitted (12). Hence, a blood culture may be falsely negative from an inadequate-volume blood culture (6). Furthermore, the blood culture contamination rate inversely correlates with the volume of blood (3). The site and method of blood collection have also been known to influence the rate of contamination of blood cultures (8). Vascular-access devices, such as arterial and central venou...

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Blood Cultures in the Critical Care Unit

Cited by 119 publications

References 73 publications

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

Effects of Volume and Site of Blood Draw on Blood Culture Results

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Blood Cultures in the Critical Care Unit

Cited by 119 publications

References 73 publications

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL

Effects of Volume and Site of Blood Draw on Blood Culture Results

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The ÂNEW SETTLERSâ: RESULTS OF a BACTERIOLOGICAL SURVEY DURING THE FIRST 6-Months OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN a TERTIARY HOSPITAL