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. 2024 Aug 2;10(16):e35615.
doi: 10.1016/j.heliyon.2024.e35615. eCollection 2024 Aug 30.

Microbiological performance and adherence in blood culture protocols: The role of a second anaerobic bottle

Paula C Vergara  1 , Cristian García  1   2   3 , Melissa Accini  1 , Liliana Franco  1   3 , Johanna M Vanegas  1 , Santiago Atehortúa  1   2   4
Affiliations

Microbiological performance and adherence in blood culture protocols: The role of a second anaerobic bottle

Paula C Vergara et al. Heliyon. .

Abstract

Background: Bacteremia represents high rates of morbidity and mortality, especially in developing countries, highlighting the need for a diagnostic method that allows prompt and appropriate patient treatment. This study compared microbiological performance and adherence of two blood culture protocols for the diagnosis of bacteremia.

Methods: Quasi-experimental study conducted between June 2022 and February 2023. Two blood culture protocols were evaluated. Protocol 1 included two aerobic bottles and one anaerobic bottle. Protocol 2 included two aerobic and two anaerobic bottles. Protocols were analyzed in three phases: evaluation of protocol 1 (Phase 1); evaluation of protocol 1 plus educational activities for healthcare staff (Phase 2) and evaluation of protocol 2 (Phase 3).

Results: 342 patients and 1155 blood culture bottles (732 aerobic and 423 anaerobic) were included. Positivity was 17.6 %, 22.8 % and 19.4 % in phases 1, 2 and 3, respectively. Among patients with bacteremia, 84.5 % had positive anaerobic bottles, with 9.9 % showing growth only in this bottle. The contamination rates were 1.9 %, 0.3 %, and 0.8 % for each phase, mainly in aerobic bottles. Median positivity time was 11 h for both bottes aerobic and anaerobic. Overall nursing adherence increased from 13.1 % in Phase 1, 25.9 % in Phase 2, and 28.1 % in Phase 3 (p = 0.009).

Conclusions: The findings indicate that adding a second anaerobic bottle does not enhance blood culture positivity. Rather than increasing bottle quantity, staff training might be a more effective approach to optimize results.

Keywords: Anaerobic bacteria; Bacteremia; Blood cultures; Clinical protocols; Education.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Positivity and contamination according to the study phases.
Fig. 2
Fig. 2
Comparison of positivity time in bottles with pathogenic microorganisms (only confirmed bacteremia).
Fig. 3
Fig. 3
Nursing staff adherence to protocols in each phase of the study.
See this image and copyright information in PMC

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