Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal Sepsis
Introduction: Despite the advantages of umbilical cord blood culture (UCBC) use for diagnosis of early onset sepsis (EOS), contamination rates have deterred neonatologists from its widespread use. We aimed to implement UCBC collection in a level III neonatal intensive care unit (NICU) and apply qual...
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| Format: | Article |
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2021.794710/full |
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| author | Vilmaris Quinones Cardona Vilmaris Quinones Cardona Vanessa Lowery David Cooperberg David Cooperberg Endla K. Anday Endla K. Anday Alison J. Carey Alison J. Carey Alison J. Carey |
| author_facet | Vilmaris Quinones Cardona Vilmaris Quinones Cardona Vanessa Lowery David Cooperberg David Cooperberg Endla K. Anday Endla K. Anday Alison J. Carey Alison J. Carey Alison J. Carey |
| author_sort | Vilmaris Quinones Cardona |
| collection | DOAJ |
| description | Introduction: Despite the advantages of umbilical cord blood culture (UCBC) use for diagnosis of early onset sepsis (EOS), contamination rates have deterred neonatologists from its widespread use. We aimed to implement UCBC collection in a level III neonatal intensive care unit (NICU) and apply quality improvement (QI) methods to reduce contamination in the diagnosis of early onset sepsis.Methods: Single-center implementation study utilizing quality improvement methodology to achieve 0% contamination rate in UCBC samples using the Plan-Do-Study-Act (PDSA) model for improvement. UCBC was obtained in conjunction with peripheral blood cultures (PBC) in neonates admitted to the NICU due to maternal chorioamnionitis. Maternal and neonatal characteristics between clinical sepsis and asymptomatic groups were compared. Process, outcome, and balancing measures were monitored.Results: Eighty-two UCBC samples were collected in addition to peripheral blood culture from neonates admitted due to maternal chorioamnionitis. Ten (12%) neonates had a diagnosis of clinical sepsis. All PBCs were negative and 5 UCBCs were positive in the study period. After 2 PDSA cycles, there was special cause variation with improvement in the percent of contaminated samples from 7.3 to 0%. There was no change in antibiotic duration among asymptomatic neonates.Conclusions: Implementation of UCBC for the diagnosis of EOS in term infants is feasible and contamination can be minimized with the implementation of a core team of trained providers and a proper sterile technique without increasing antibiotic duration. |
| first_indexed | 2024-12-21T23:48:11Z |
| format | Article |
| id | doaj.art-d1074b1c10794a3a9a05e5384c60e8d3 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-21T23:48:11Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-d1074b1c10794a3a9a05e5384c60e8d32022-12-21T18:46:00ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-12-01910.3389/fped.2021.794710794710Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal SepsisVilmaris Quinones Cardona0Vilmaris Quinones Cardona1Vanessa Lowery2David Cooperberg3David Cooperberg4Endla K. Anday5Endla K. Anday6Alison J. Carey7Alison J. Carey8Alison J. Carey9Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, United StatesDepartment of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, United StatesDepartment of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, United StatesDepartment of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, United StatesDepartment of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, United StatesDepartment of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, United StatesDepartment of Pediatrics, Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, PA, United StatesDepartment of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, United StatesDepartment of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, United StatesDepartment of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, United StatesIntroduction: Despite the advantages of umbilical cord blood culture (UCBC) use for diagnosis of early onset sepsis (EOS), contamination rates have deterred neonatologists from its widespread use. We aimed to implement UCBC collection in a level III neonatal intensive care unit (NICU) and apply quality improvement (QI) methods to reduce contamination in the diagnosis of early onset sepsis.Methods: Single-center implementation study utilizing quality improvement methodology to achieve 0% contamination rate in UCBC samples using the Plan-Do-Study-Act (PDSA) model for improvement. UCBC was obtained in conjunction with peripheral blood cultures (PBC) in neonates admitted to the NICU due to maternal chorioamnionitis. Maternal and neonatal characteristics between clinical sepsis and asymptomatic groups were compared. Process, outcome, and balancing measures were monitored.Results: Eighty-two UCBC samples were collected in addition to peripheral blood culture from neonates admitted due to maternal chorioamnionitis. Ten (12%) neonates had a diagnosis of clinical sepsis. All PBCs were negative and 5 UCBCs were positive in the study period. After 2 PDSA cycles, there was special cause variation with improvement in the percent of contaminated samples from 7.3 to 0%. There was no change in antibiotic duration among asymptomatic neonates.Conclusions: Implementation of UCBC for the diagnosis of EOS in term infants is feasible and contamination can be minimized with the implementation of a core team of trained providers and a proper sterile technique without increasing antibiotic duration.https://www.frontiersin.org/articles/10.3389/fped.2021.794710/fullearly onset sepsis (EOS)umbilical cord blood (UCB)quality improvement (QI)peripheral blood culture (PBC)umbilical cord blood culture (UCBC) |
| spellingShingle | Vilmaris Quinones Cardona Vilmaris Quinones Cardona Vanessa Lowery David Cooperberg David Cooperberg Endla K. Anday Endla K. Anday Alison J. Carey Alison J. Carey Alison J. Carey Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal Sepsis Frontiers in Pediatrics early onset sepsis (EOS) umbilical cord blood (UCB) quality improvement (QI) peripheral blood culture (PBC) umbilical cord blood culture (UCBC) |
| title | Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal Sepsis |
| title_full | Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal Sepsis |
| title_fullStr | Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal Sepsis |
| title_full_unstemmed | Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal Sepsis |
| title_short | Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal Sepsis |
| title_sort | eliminating contamination in umbilical cord blood culture sampling for early onset neonatal sepsis |
| topic | early onset sepsis (EOS) umbilical cord blood (UCB) quality improvement (QI) peripheral blood culture (PBC) umbilical cord blood culture (UCBC) |
| url | https://www.frontiersin.org/articles/10.3389/fped.2021.794710/full |
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