Abstract
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. This single-center, prospective observational study of 249 consecutive patients aged ≥ 20 years proceeded in the ED of a university hospital in Japan during 6 months. Pairs of blood samples were collected for aerobic and anaerobic culture from all patients in the ED. Physicians selected puncture sites and topical disinfectants according to their personal preference. We found 50 (20.1%) patients with potentially contaminated blood cultures. Fifty-six (22.5%) patients were true bacteremia and 143 (57.4%) patients were true negatives. Multivariate analysis associated more frequent contamination when puncture sites were disinfected with povidone-iodine than with alcohol/chlorhexidine (adjusted risk difference, 12.9%; 95% confidence interval [CI] 8.8–16.9; P < 0.001). Sites of blood collection were also associated with contamination. Femoral and central venous with other sites were associated with contamination more frequently than venous sites (adjusted risk difference), 13.1% (95% CI 8.2–17.9; P < 0.001]) vs. 17.3% (95% CI 3.6–31.0; P = 0.013). Rates of contaminated blood cultures were significantly higher when blood was collected from femoral sites and when povidone-iodine was the topical antiseptic.
Highlights
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
We aimed to determine whether puncture sites for blood sampling and topical antiseptics are associated with blood culture contamination in a single ED
With reference to femoral sites and alcohol/chlorhexidine gluconate (ACHX), PVI and femoral sites, and PVI and central venous (CV) Other were significantly associated with contamination, whereas PVI and venous, ACHX and CV Other and ACHX and venous sites were not (Table 4). This single center, prospective observational study found that blood samples collected from femoral areas disinfected with PVI were significantly associated with contaminated blood cultures
Summary
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. The rates of false-positive cultures are significantly reduced when blood is sampled from various venipuncture sites compared with intravenous or central venous catheters[9,10]. Physicians at our institution may sample blood from various sites, such as intravenous and central venous catheters, as well as femoral arteries and veins according to personal preference Those in our emergency department (ED) tend to sample blood from femoral arteries or veins, yet little is understood about associations between puncture sites for blood sampling and false-positive blood cultures.
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