The preanalytical optimization of blood cultures: a review and the clinical importance of benchmarking in 5 Belgian hospitals

Willems, Elise; Smismans, Annick; Cartuyvels, Reinoud; Coppens, G.; Vaerenbergh, Kristien Van; Abeele, Anne‐Marie Van den; Frans, Johan

doi:10.1016/j.diagmicrobio.2012.01.009

Cited by 48 publications

(51 citation statements)

References 59 publications

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“…found that only 45% of patients had adequate numbers of BC sets and only 13% had optimal sample volumes (that is ≥10 ml per bottle) [28]. The authors of a review on true-positive rate, contamination rate, and collected blood volume of BC bottles in five Belgian hospital laboratories found that more than one-third of the BC bottles handled were incorrectly filled, irrespective of the manufacturer of the blood culture vials [29]. …”

Section: Discussionmentioning

confidence: 99%

Quality of blood culture testing - a survey in intensive care units and microbiological laboratories across four European countries

et al. 2013

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IntroductionBlood culture (BC) testing before initiation of antimicrobial therapy is recommended as a standard of care in international sepsis guidelines and has been shown to reduce intensive care unit (ICU) stay, antibiotic use, and costs in hospitalized patients. Whereas microbiological laboratory practice has been highly standardized, shortfalls in the preanalytic procedures in the ICU (that is indication, time-to-incubation, blood volume and numbers of BC sets) have a significant effect on the diagnostic yield. The objective of this study was to gain insights into current practices regarding BC testing in intensive care units.MethodsQualitative survey, data collection by 138 semi-structured telephone interviews in four European countries (Italy, UK, France and Germany) between September and November 2009 in 79 clinical microbiology laboratories (LABs) and 59 ICUs.ResultsWhereas BC testing is expected to remain the gold standard for sepsis diagnostics in all countries, there are substantial differences regarding preanalytic procedures. The decision to launch BC testing is carried out by physicians vs. ICU nurses in the UK in 92 vs. 8%, in France in 75 vs. 25%, in Italy in 88 vs. 12% and in Germany in 92 vs. 8%. Physicians vs. nurses collect BCs in the UK in 77 vs. 23%, in France in 0 vs. 100%, in Italy in 6 vs. 94% and in Germany in 54 vs. 46%. The mean time from blood collection to incubation in the UK is 2 h, in France 3 h, in Italy 4 h, but 20 h in German remote LABs (2 h in in-house LABs), due to the large number of remote nonresident microbiological laboratories in Germany. There were major differences between the perception of the quality of BC testing between ICUs and LABs. Among German ICU respondents, 62% reported that they have no problems with BC testing, 15% reported time constraints, 15% cost pressure, and only 8% too long time to incubation. However, the corresponding LABs of these German ICUs reported too many false positive results due to preanalytical contaminations (49%), insufficient numbers of incoming BC sets (47%), long transportation time (41%) or cost pressure (18%).ConclusionsThere are considerable differences in the quality of BC testing across European countries. In Germany, time to incubation is a considerable problem due to the increasing number of remote LABs. This is a major issue of concern to physicians aiming to implement sepsis guidelines in the ICUs.

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Section: Discussionmentioning

confidence: 99%

Quality of blood culture testing - a survey in intensive care units and microbiological laboratories across four European countries

et al. 2013

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“…BCs may be performed selectively in patients with pneumonia or skin-soft tissue infections. 51 The review also provides a listing of indications for follow-up BCs.…”

Section: Clinical Indications For Bcsmentioning

confidence: 99%

“…Commercial bottles contain substantially more vacuum than is needed to adequately fill the bottles, ensuring rapid filling. 51,123 Obtaining blood for culture with a bottle in a horizontal position allows for only an estimate of the proper quantity. Although the bottle has a printed volume scale, it only helps if the bottle is maintained in a vertical position during filling.…”

Section: Volumementioning

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

109

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“…The weight difference in grams was divided by the density of blood (1.060 g/ml [4]) to measure the volume of blood in the bottle. We used a volume of 8 ml (i.e., 2 ml below the recommended volume) as the minimal norm, as previously proposed (5). All data were stored and analyzed using SPSS version 18.0 (IBM).…”

mentioning

confidence: 99%

Education of Phlebotomy Teams Improves Blood Volume in Blood Culture Bottles

2013

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bThe volume of blood sampled for blood culture determines its sensitivity. We measured low mean blood volumes in submitted aerobic (8.38 ؎ 3.88 ml) and anaerobic (7.16 ؎ 3.83 ml) blood culture bottles. Educational seminars were held for phlebotomy teams, and renewed measurements thereafter revealed significantly higher blood volumes in submitted aerobic (9.77 ؎ 4.42 ml) and anaerobic (8.30 ؎ 3.64 ml) bottles. Education of phlebotomy teams improves the blood volume in blood culture bottles and should be part of quality control procedures.

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The preanalytical optimization of blood cultures: a review and the clinical importance of benchmarking in 5 Belgian hospitals

Cited by 48 publications

References 59 publications

Quality of blood culture testing - a survey in intensive care units and microbiological laboratories across four European countries

Quality of blood culture testing - a survey in intensive care units and microbiological laboratories across four European countries

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

Education of Phlebotomy Teams Improves Blood Volume in Blood Culture Bottles

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