Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University Hospital
<b>Background</b>: Bloodstream infections increase morbidity and mortality in hospitalized patients and pose a significant burden for health care systems worldwide. Optimal blood culture diagnostics are essential for early detection and specific treatment. After assessing the quality par...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/13/3675 |
| _version_ | 1797443119593029632 |
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| author | Sarah V. Walker Benedict Steffens David Sander Wolfgang A. Wetsch |
| author_facet | Sarah V. Walker Benedict Steffens David Sander Wolfgang A. Wetsch |
| author_sort | Sarah V. Walker |
| collection | DOAJ |
| description | <b>Background</b>: Bloodstream infections increase morbidity and mortality in hospitalized patients and pose a significant burden for health care systems worldwide. Optimal blood culture diagnostics are essential for early detection and specific treatment. After assessing the quality parameters at a surgical intensive care unit for six months, we implemented a diagnostic stewardship bundle (DSB) to optimize blood culture diagnostics and then reevaluated its effects after six months. <b>Material and Methods:</b> All patients ≥18 years old and on the ward were included: pre-DSB 137 and post-DSB 158. The standard quality parameters were defined as the number of blood culture sets per diagnostic episode (≥2), the rate of contamination (2–3%), the rate of positivity (5–15%), the collection site (≥1 venipuncture per episode) and the filling volume of the bottles (8–10 mL, only post-DSB). The DSB included an informational video, a standard operating procedure, and ready-to-use paper crates with three culture sets. <b>Results:</b> From pre- to post-interventional, the number of ≥2 culture sets per episode increased from 63.9% (257/402) to 81.3% (230/283), and venipunctures increased from 42.5% (171/402) to 77.4% (219/283). The positivity rate decreased from 15.1% (108/714) to 12.8% (83/650), as did the contamination rate (3.8% to 3.6%). The majority of the aerobic bottles were filled within the target range (255/471, 54.1%), but in 96.6%, the anaerobic bottles were overfilled (451/467). <b>Conclusions:</b> The implementation of DSB improved the quality parameters at the unit, thus optimizing the blood culture diagnostics. Further measures seem necessary to decrease the contamination rate and optimize bottle filling significantly. |
| first_indexed | 2024-03-09T12:51:26Z |
| format | Article |
| id | doaj.art-e646383f284d4ef0abbecb47f01b1395 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T12:51:26Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-e646383f284d4ef0abbecb47f01b13952023-11-30T22:06:40ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011113367510.3390/jcm11133675Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University HospitalSarah V. Walker0Benedict Steffens1David Sander2Wolfgang A. Wetsch3Faculty of Medicine, University of Cologne, 50923 Cologne, GermanyFaculty of Medicine, University of Cologne, 50923 Cologne, GermanyFaculty of Medicine, University of Cologne, 50923 Cologne, GermanyFaculty of Medicine, University of Cologne, 50923 Cologne, Germany<b>Background</b>: Bloodstream infections increase morbidity and mortality in hospitalized patients and pose a significant burden for health care systems worldwide. Optimal blood culture diagnostics are essential for early detection and specific treatment. After assessing the quality parameters at a surgical intensive care unit for six months, we implemented a diagnostic stewardship bundle (DSB) to optimize blood culture diagnostics and then reevaluated its effects after six months. <b>Material and Methods:</b> All patients ≥18 years old and on the ward were included: pre-DSB 137 and post-DSB 158. The standard quality parameters were defined as the number of blood culture sets per diagnostic episode (≥2), the rate of contamination (2–3%), the rate of positivity (5–15%), the collection site (≥1 venipuncture per episode) and the filling volume of the bottles (8–10 mL, only post-DSB). The DSB included an informational video, a standard operating procedure, and ready-to-use paper crates with three culture sets. <b>Results:</b> From pre- to post-interventional, the number of ≥2 culture sets per episode increased from 63.9% (257/402) to 81.3% (230/283), and venipunctures increased from 42.5% (171/402) to 77.4% (219/283). The positivity rate decreased from 15.1% (108/714) to 12.8% (83/650), as did the contamination rate (3.8% to 3.6%). The majority of the aerobic bottles were filled within the target range (255/471, 54.1%), but in 96.6%, the anaerobic bottles were overfilled (451/467). <b>Conclusions:</b> The implementation of DSB improved the quality parameters at the unit, thus optimizing the blood culture diagnostics. Further measures seem necessary to decrease the contamination rate and optimize bottle filling significantly.https://www.mdpi.com/2077-0383/11/13/3675antibiotic stewardshipdiagnostic stewardshipblood culturebloodstream infectionbacteremia |
| spellingShingle | Sarah V. Walker Benedict Steffens David Sander Wolfgang A. Wetsch Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University Hospital Journal of Clinical Medicine antibiotic stewardship diagnostic stewardship blood culture bloodstream infection bacteremia |
| title | Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University Hospital |
| title_full | Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University Hospital |
| title_fullStr | Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University Hospital |
| title_full_unstemmed | Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University Hospital |
| title_short | Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University Hospital |
| title_sort | implementation of antibiotic stewardship improves the quality of blood culture diagnostics at an intensive care unit of a university hospital |
| topic | antibiotic stewardship diagnostic stewardship blood culture bloodstream infection bacteremia |
| url | https://www.mdpi.com/2077-0383/11/13/3675 |
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