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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 bacteraemia and contamination have been explored. In our study the contamination rates of blood cultures drawn by phlebotomy in the ICU ward was determined and the impact of false positive blood culture tests on health care costs of patients due to extended lengths of stay and unnecessary treatment with drugs was also determined. Later after training the nurses in the ICU and by using the disinfectant with appropriate contact time, the contamination rates came down to 5.3% (though the guidelines say 2-3% as the accepted contamination rates allowed). Since it was a pilot study, intervention was done only in the ICU. Probably the same can be tried by appointing a phlebotomist and it can be practised in all wards; then surely contamination rates will come down to less than 3%. By maintaining vigilance with preparation, by appropriate utilization of equipment, sampling techniques and by giving feed back to the staff concerned regarding contamination rates, it is possible to make the move towards zero false positives.
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Author(s): Anila A Mathews B Appalaraju K Siddharth
Blood culture, Bacteraemia