The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol
Abstract Background Blood cultures are an integral part of the diagnosis of bacteremia in unwell patients. The treatment of bacteremia involves the rapid and accurate identification of the causative agent grown from the blood cultures collected. Contamination of blood cultures with non-pathogenic mi...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-11-01
|
| Series: | Systematic Reviews |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13643-018-0877-4 |
| _version_ | 1819117028101849088 |
|---|---|
| author | J. A. Hughes C. J. Cabilan Julian Williams Mercedes Ray Fiona Coyer |
| author_facet | J. A. Hughes C. J. Cabilan Julian Williams Mercedes Ray Fiona Coyer |
| author_sort | J. A. Hughes |
| collection | DOAJ |
| description | Abstract Background Blood cultures are an integral part of the diagnosis of bacteremia in unwell patients. The treatment of bacteremia involves the rapid and accurate identification of the causative agent grown from the blood cultures collected. Contamination of blood cultures with non-pathogenic microbes such as skin commensals causes false positive results and subsequent unnecessary and potentially harmful interventions. While guidelines for blood culture quality recommend no more than 2–3% contamination rate, rates up to 12% are reported in the literature. There have been a number of methods proposed to reduce the contamination of blood cultures, including educational interventions, changing of skin cleansing preparations and introduction of blood culture collection packs in acute care settings. This protocol outlines methods to identify and evaluate interventions to reduce blood culture contamination in the acute care setting. Methods The reviewers will conduct a systematic search of literature in CINHAL, PubMed, EMBASE and the Cochrane Central register of controlled trials. Unpublished works will be identified in ProQuest Dissertations and Theses. Articles will be assessed for relevance based on their title and abstract. Remaining relevant citations will have their full text retrieved and assessed against eligibility criteria. All studies that meet the eligibility criteria will have their methodological quality appraised. Assessments for relevance and methodological quality will be conducted independently by two reviewers. If appropriate, data will be analysed using the Mantel-Haenszel method under a random effects model. Heterogeneity of the studies will be assessed using the I 2 and chi-squared statistic. Meta-analysis will be attempted if the data is suitable. Discussion This review will identify and summarise the interventions previously described in the literature aimed at reducing peripherally collected blood culture contamination rates in acute care. These findings have the potential to lead to multifaceted interventions based on previous evidence to reduce blood culture contamination in the acute setting. Reductions in the proportion of contaminated blood cultures have the potential to save money, unrequired treatment (particularly antimicrobials) and hospital bed days. Systematic review registration In accordance with guidelines outlined in the PRISMA-P methodology, this protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on December 8, 2017, and last updated on January 4, 2018 (registration number CRD42017081650). |
| first_indexed | 2024-12-22T05:26:28Z |
| format | Article |
| id | doaj.art-a7e867a3209e4e04ba14469836b42056 |
| institution | Directory Open Access Journal |
| issn | 2046-4053 |
| language | English |
| last_indexed | 2024-12-22T05:26:28Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj.art-a7e867a3209e4e04ba14469836b420562022-12-21T18:37:34ZengBMCSystematic Reviews2046-40532018-11-01711610.1186/s13643-018-0877-4The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocolJ. A. Hughes0C. J. Cabilan1Julian Williams2Mercedes Ray3Fiona Coyer4School of Nursing, Queensland University of TechnologyClinical Research Officer, Emergency Department, Princess Alexandra HospitalEmergency and Trauma Centre, Royal Brisbane and Women’s HospitalEmergency and Trauma Centre, Royal Brisbane and Women’s HospitalSchool of Nursing, Queensland University of TechnologyAbstract Background Blood cultures are an integral part of the diagnosis of bacteremia in unwell patients. The treatment of bacteremia involves the rapid and accurate identification of the causative agent grown from the blood cultures collected. Contamination of blood cultures with non-pathogenic microbes such as skin commensals causes false positive results and subsequent unnecessary and potentially harmful interventions. While guidelines for blood culture quality recommend no more than 2–3% contamination rate, rates up to 12% are reported in the literature. There have been a number of methods proposed to reduce the contamination of blood cultures, including educational interventions, changing of skin cleansing preparations and introduction of blood culture collection packs in acute care settings. This protocol outlines methods to identify and evaluate interventions to reduce blood culture contamination in the acute care setting. Methods The reviewers will conduct a systematic search of literature in CINHAL, PubMed, EMBASE and the Cochrane Central register of controlled trials. Unpublished works will be identified in ProQuest Dissertations and Theses. Articles will be assessed for relevance based on their title and abstract. Remaining relevant citations will have their full text retrieved and assessed against eligibility criteria. All studies that meet the eligibility criteria will have their methodological quality appraised. Assessments for relevance and methodological quality will be conducted independently by two reviewers. If appropriate, data will be analysed using the Mantel-Haenszel method under a random effects model. Heterogeneity of the studies will be assessed using the I 2 and chi-squared statistic. Meta-analysis will be attempted if the data is suitable. Discussion This review will identify and summarise the interventions previously described in the literature aimed at reducing peripherally collected blood culture contamination rates in acute care. These findings have the potential to lead to multifaceted interventions based on previous evidence to reduce blood culture contamination in the acute setting. Reductions in the proportion of contaminated blood cultures have the potential to save money, unrequired treatment (particularly antimicrobials) and hospital bed days. Systematic review registration In accordance with guidelines outlined in the PRISMA-P methodology, this protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on December 8, 2017, and last updated on January 4, 2018 (registration number CRD42017081650).http://link.springer.com/article/10.1186/s13643-018-0877-4Systematic reviewBlood cultureContaminationMicrobial contaminationAcute carePeripheral blood collection |
| spellingShingle | J. A. Hughes C. J. Cabilan Julian Williams Mercedes Ray Fiona Coyer The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol Systematic Reviews Systematic review Blood culture Contamination Microbial contamination Acute care Peripheral blood collection |
| title | The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol |
| title_full | The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol |
| title_fullStr | The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol |
| title_full_unstemmed | The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol |
| title_short | The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol |
| title_sort | effectiveness of interventions to reduce peripheral blood culture contamination in acute care a systematic review protocol |
| topic | Systematic review Blood culture Contamination Microbial contamination Acute care Peripheral blood collection |
| url | http://link.springer.com/article/10.1186/s13643-018-0877-4 |
| work_keys_str_mv | AT jahughes theeffectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT cjcabilan theeffectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT julianwilliams theeffectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT mercedesray theeffectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT fionacoyer theeffectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT jahughes effectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT cjcabilan effectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT julianwilliams effectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT mercedesray effectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol AT fionacoyer effectivenessofinterventionstoreduceperipheralbloodculturecontaminationinacutecareasystematicreviewprotocol |