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. 2024 Dec 31;19(12):e0314649.
doi: 10.1371/journal.pone.0314649. eCollection 2024.

Effect of a blood culture collection bundle on decreasing the contamination rate

Miki Doi  1 , Yoshio Takesue  2   3 , Miyuki Makino  3 , Yousuke Kihara  3 , Akiko Tanikawa  3 , Yasushi Murakami  4 , Hitoshi Ogashiwa  1 , Yukiko Nakano  1 , Soichiro Nakama  3 , Takashi Ueda  2 , Kazuhiko Nakajima  2 , Yasuhiro Nozaki  4
Affiliations

Effect of a blood culture collection bundle on decreasing the contamination rate

Miki Doi et al. PLoS One. .

Abstract

In this study, we examined the effect of a bundled approach to blood collection for blood culture on decreasing contamination. Commensal organisms were considered contaminants on the basis of the clinical course if they were recovered from only a single blood draw (set) and if a positive result for two sets was not obtained within 72 hours. The main elements of the bundle were blood collection by venipuncture, skin preparation with a chlorhexidine alcohol swab, disinfection of culture bottles, and use of a sterile blood transfer device instead of the two-needle technique for inoculation. In the bundle intervention, chlorhexidine alcohol was first introduced in the hospital, and use of the blood transfer device was increased during the intervention. Both items were used in most patients requiring blood cultures. Blood collection through a line caused contamination in only one case. The contamination rate decreased significantly from 2.0% to 1.0% after introduction of the bundle approach (3-year control period vs. 2-year bundle period, p<0.001), and a significant decrease in the contamination rate was observed for coagulase-negative Staphylococcus (p<0.001). A high contamination rate was found in August and September during the control period. The contamination rate of Bacillus species was significantly higher in those 2 months than in other months. A seasonal increase was not observed during the bundle period. A low contamination rate of 1.0% was achieved using our bundled collection approach for blood culture.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Semiannual analysis of monthly use of skin disinfection swab sets in the hospital.
A. May 2019 to April 2022; B. May 2022 to April 2024. Gray bar chart: povidone-iodine, Black bar chart:1% chlorhexidine-alcohol.
Fig 2
Fig 2. Semiannual analysis of monthly use of sterile blood transfer devices.
A. May 2019 to April 2022; B. May 2022 to April 2024.
Fig 3
Fig 3. Changes in the monthly contamination rate (per set) in blood culture (BC).
A. Control period, Open triangles solid line: May 2019 to Apr 2020, Open square solid line: May 2020 to Apr 2021, Open circles solid line: May 2021 to Apr 2022. B. Bundle period, Solid triangles dotted line: May 2022 to Apr 2023, Solid circles dotted line May 2023 to Apr 2024.
See this image and copyright information in PMC

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