Sites of blood collection and topical disinfectants associated with contaminated cultures: An ambidirectional cohort study
Abstract Background We aimed to determine whether puncture sites for blood sampling and topical disinfectants are associated with rates of contaminated blood cultures in the emergency department (ED) of a single institution. Methods This single‐center, ambidirectional cohort study of 548 consecutive...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Journal of General and Family Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgf2.667 |
| _version_ | 1827352762500775936 |
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| author | Koshi Ota Daisuke Nishioka Emi Hamada Kanna Ota Yuriko Shibata Akira Takasu |
| author_facet | Koshi Ota Daisuke Nishioka Emi Hamada Kanna Ota Yuriko Shibata Akira Takasu |
| author_sort | Koshi Ota |
| collection | DOAJ |
| description | Abstract Background We aimed to determine whether puncture sites for blood sampling and topical disinfectants are associated with rates of contaminated blood cultures in the emergency department (ED) of a single institution. Methods This single‐center, ambidirectional cohort study of 548 consecutive patients ≥20 years of age was performed in the ED of a university hospital in Japan over a 13‐month period. Pairs of blood samples were collected for aerobic and anaerobic cultures from patients in the ED. Physicians selected puncture sites and topical disinfectants according to their personal preference. Results Potential contamination was identified in 110 of the 548 patients (20.1%). One hundred fourteen (20.8%) patients showed true‐positive results for bacteremia, and 324 (59.1%) patients showed true‐negative results. Multivariate analysis revealed more frequent contamination when puncture sites were disinfected with povidone‐iodine (PVI) than with alcohol/chlorhexidine (ACHX) (adjusted risk difference, 19.1%; 95% confidence interval [CI]), 15.7–22.6; p < 0.001). In terms of blood collection sites, femoral and central venous (CV) catheter with PVI disinfection showed more frequent contamination than venous sites with ACHX (adjusted risk differences: 26.6%, 95% CI 21.3–31.9, p < 0.001 and 41.1%, 95% CI 22.2–59.9, p < 0.001, respectively). Conclusion Rates of contaminated blood cultures were significantly higher when blood was collected from the CV catheter or femoral sites with PVI as the topical disinfectant. |
| first_indexed | 2024-03-08T03:11:42Z |
| format | Article |
| id | doaj.art-53b6ec8edbb54f3abb713e153d9f7604 |
| institution | Directory Open Access Journal |
| issn | 2189-7948 |
| language | English |
| last_indexed | 2024-03-08T03:11:42Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of General and Family Medicine |
| spelling | doaj.art-53b6ec8edbb54f3abb713e153d9f76042024-02-13T04:25:50ZengWileyJournal of General and Family Medicine2189-79482024-01-01251455210.1002/jgf2.667Sites of blood collection and topical disinfectants associated with contaminated cultures: An ambidirectional cohort studyKoshi Ota0Daisuke Nishioka1Emi Hamada2Kanna Ota3Yuriko Shibata4Akira Takasu5Department of Emergency Medicine Osaka Medical and Pharmaceutical University Takatsuki City JapanResearch and Development Center Osaka Medical and Pharmaceutical University Takatsuki City JapanDepartment of Nursing Osaka Medical and Pharmaceutical University Hospital Takatsuki City JapanDepartment of Emergency Medicine Osaka Medical and Pharmaceutical University Takatsuki City JapanDepartment of Clinical Laboratory Osaka Medical and Pharmaceutical University Hospital Takatsuki City JapanDepartment of Emergency Medicine Osaka Medical and Pharmaceutical University Takatsuki City JapanAbstract Background We aimed to determine whether puncture sites for blood sampling and topical disinfectants are associated with rates of contaminated blood cultures in the emergency department (ED) of a single institution. Methods This single‐center, ambidirectional cohort study of 548 consecutive patients ≥20 years of age was performed in the ED of a university hospital in Japan over a 13‐month period. Pairs of blood samples were collected for aerobic and anaerobic cultures from patients in the ED. Physicians selected puncture sites and topical disinfectants according to their personal preference. Results Potential contamination was identified in 110 of the 548 patients (20.1%). One hundred fourteen (20.8%) patients showed true‐positive results for bacteremia, and 324 (59.1%) patients showed true‐negative results. Multivariate analysis revealed more frequent contamination when puncture sites were disinfected with povidone‐iodine (PVI) than with alcohol/chlorhexidine (ACHX) (adjusted risk difference, 19.1%; 95% confidence interval [CI]), 15.7–22.6; p < 0.001). In terms of blood collection sites, femoral and central venous (CV) catheter with PVI disinfection showed more frequent contamination than venous sites with ACHX (adjusted risk differences: 26.6%, 95% CI 21.3–31.9, p < 0.001 and 41.1%, 95% CI 22.2–59.9, p < 0.001, respectively). Conclusion Rates of contaminated blood cultures were significantly higher when blood was collected from the CV catheter or femoral sites with PVI as the topical disinfectant.https://doi.org/10.1002/jgf2.667blood culturecontaminationsitetopical disinfectant |
| spellingShingle | Koshi Ota Daisuke Nishioka Emi Hamada Kanna Ota Yuriko Shibata Akira Takasu Sites of blood collection and topical disinfectants associated with contaminated cultures: An ambidirectional cohort study Journal of General and Family Medicine blood culture contamination site topical disinfectant |
| title | Sites of blood collection and topical disinfectants associated with contaminated cultures: An ambidirectional cohort study |
| title_full | Sites of blood collection and topical disinfectants associated with contaminated cultures: An ambidirectional cohort study |
| title_fullStr | Sites of blood collection and topical disinfectants associated with contaminated cultures: An ambidirectional cohort study |
| title_full_unstemmed | Sites of blood collection and topical disinfectants associated with contaminated cultures: An ambidirectional cohort study |
| title_short | Sites of blood collection and topical disinfectants associated with contaminated cultures: An ambidirectional cohort study |
| title_sort | sites of blood collection and topical disinfectants associated with contaminated cultures an ambidirectional cohort study |
| topic | blood culture contamination site topical disinfectant |
| url | https://doi.org/10.1002/jgf2.667 |
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