Effect of Routine Sterile Gloving on Contamination Rates in Blood Culture

Kim, Nak-Hyun; Kim, Moonsuk; Lee, Shinwon; Yun, Na Ra; Kim, Kye-Hyung; Park, Sang Won; Kim, Hong Bin; Kim, Nam Joong; Kim, Eui-Chong; Park, Wan Beom; Oh, Myoung Don

doi:10.7326/0003-4819-154-3-201102010-00003

Cited by 50 publications

(32 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, a randomised cross-over trial by Kim et al [10] found that routine use of sterile gloves was associated with a reduction in BC contamination.…”

Section: Discussionmentioning

confidence: 99%

Time for a culture change? Suboptimal compliance with blood culture standards at a district hospital in Cape Town

2015

View full text Add to dashboard Cite

Background. The benchmark for contaminated blood cultures (BCs) is 3%. The South African (SA) guideline aims to optimise BC yield and reduce contamination. Data on BC collection practices in SA since the publication of the 2010 SA guideline are lacking. Objective. To evaluate compliance with the national guideline for the optimal use of BCs and determine the BC contamination rate at a local district hospital.Method. An audit of compliance with 22 BC standards was conducted at a district hospital in Cape Town, SA. Standards were evaluated by reviewing clinical and laboratory data and by a clinician questionnaire. Results. Of the 425 BCs reviewed, 12.5% had positive growth, and 4.5% grew contaminants. Only 33% of BC bottles contained the recommended fill volume of 8 -10 mL, and 96.9% of patients had a single BC within a 24-hour period. Of all the BCs, only 7.8% had a combined blood volume of at least 20 mL. The yield of pathogens in BCs collected after antibiotic exposure was 4.9% compared with 7.5% for those cultures with no prior antibiotic exposure (p=0.3). The overall median needle-to-incubator transport time was 11 hours 25 minutes. Conclusion. The BC contamination rate was high and compliance with most standards was variable or not met. The findings may not be generalisable to other hospitals, and we recommend that each institution reviews its own BC practices. Recommendations made to hospital staff included a re-audit following implementation of these recommendations.

show abstract

“…However, a randomised cross-over trial by Kim et al [10] found that routine use of sterile gloves was associated with a reduction in BC contamination.…”

Section: Discussionmentioning

confidence: 99%

Time for a culture change? Suboptimal compliance with blood culture standards at a district hospital in Cape Town

2015

View full text Add to dashboard Cite

show abstract

“…The only study addressing this intervention was designed as a cluster randomized, assessor-blinded, crossover trial at a single hospital in medical wards and an ICU. 111 Interns drawing blood via venipuncture were randomly assigned to use either sterile gloves for all procedures or optional sterile gloves when re-palpating the vein after disinfection of the skin site. Significant differences were seen in the contamination rates: 0.6% in routine sterile gloving, and 1.1% when sterile gloves were optional.…”

Section: Sterile Glovesmentioning

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

112

View full text Add to dashboard Cite

“…Excess contamination rates are driven primarily by a lack of operator fastidiousness during the collection process (3). As such, interventions such as dedicated phlebotomy teams, prepackaged blood culture kits, and the use of sterile gloves have helped decrease contamination rates (4,5).…”

mentioning

confidence: 99%

Impact of Hourly Emergency Department Patient Volume on Blood Culture Contamination and Diagnostic Yield

et al. 2013

View full text Add to dashboard Cite

Emergency departments (EDs) are an important diagnostic site for outpatients with potentially serious infections. EDs frequently experience high patient volumes, and crowding has been shown to negatively impact the delivery of early care for serious infections, such as pneumonia. Here, we hypothesized that other important factors in the early care of infectious diseases, the rate of blood culture contamination and the accurate detection of pathogens, would be sensitive to ED operational stress, as proper collection requires fastidious attention to technique and timing. We related all blood samples collected over 1 year and their rates of recovery of likely contaminants and pathogens to the number of patients being cared for in the ED at the time of sample collection. Likely pathogens and contaminants were classified through combined microbiological and manual chart review criteria. Zero-inflated Poisson regression was used to relate crowding to culture results. Blood samples were obtained from 7,586 patients over 82,521 adult and pediatric patient visits. The unadjusted rates of recovering a likely pathogen or a likely contaminant were 8.0% and 3.7%, respectively. Periods of increased crowding (3rd and 4th quartiles of hourly occupancy) were significantly associated (P < 0.01) with increased rates of contamination (relative risk, 1.23 compared to the least busy quartile). Collecting samples for culture during busy times was also associated with a reduced likelihood of recovering a likely pathogen (relative risk, 0.93 compared to the least busy quartile). ED crowding was associated with degraded performance of blood cultures, both increasing the rate of contamination and decreasing the diagnostic yield. Despite considerable efforts to reduce their incidence, contaminated blood cultures continue to be a significant clinical problem. Ongoing multicenter monitoring in the United States places the median rate of contamination at just under 3% (lower national quartile, 2.15%; upper quartile, 3.67%) (1). The clinical and financial impacts of contaminated cultures have been examined by numerous groups; the most recently published results indicate that among patients undergoing blood culture during emergency department (ED) evaluation and subsequent admission to the hospital, a false-positive culture adds an estimated $8,700 (2008 U.S. dollars) and an additional day of hospitalization (2). Excess contamination rates are driven primarily by a lack of operator fastidiousness during the collection process (3). As such, interventions such as dedicated phlebotomy teams, prepackaged blood culture kits, and the use of sterile gloves have helped decrease contamination rates (4, 5).One clinical setting about which little is known regarding blood culture contamination is the emergency department (ED). EDs are an important and common site for initial diagnosis and treatment; more than 136 million visits took place in 2009, the most recent year for which Centers for Disease Control and Prevention data are available (6). Increasingly...

show abstract

Effect of Routine Sterile Gloving on Contamination Rates in Blood Culture

Abstract: Routine sterile gloving before venipuncture may reduce blood culture contamination.

Cited by 50 publications

References 19 publications

Time for a culture change? Suboptimal compliance with blood culture standards at a district hospital in Cape Town

Time for a culture change? Suboptimal compliance with blood culture standards at a district hospital in Cape Town

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

Impact of Hourly Emergency Department Patient Volume on Blood Culture Contamination and Diagnostic Yield

Contact Info

Product

Resources

About