Factors Impacting the Pre-analytical Quality of Blood Cultures-Analysis at a Tertiary Medical Center

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Mar 17

PMID 36928259

Authors

Lucas Romann

Laura Werlen

Nikki Rommers

Anja Hermann

Isabelle Gisler

Stefano Bassetti

Roland Bingisser

Martin Siegemund

Tim Roloff

Maja Weisser

Veronika Muigg

Vladimira Hinic

Michael Osthoff

Fabian C Franzeck

Adrian Egli

Affiliations

Soon will be listed here.

Abstract

Background: Blood cultures (BC) are critical for the diagnosis of bloodstream infections, pathogen identification, and resistance testing. Guidelines recommend a blood volume of 8-10 mL per bottle as lower volumes result in decreased sensitivity. We aimed to evaluate factors for non-adherence to recommended volumes and assess the effects on diagnostic performance.

Methods: From February to April 2020, we measured collected blood volumes by weighing all BC containers from inpatient samples at the University Hospital Basel. Information on BC volumes was merged with clinical and microbiological data, as well as nursing staff schedules. We analyzed factors associated with (i) BC sampling volume, (ii) reaching recommended volumes (≥8 mL), (iii) BC positivity, and (iv) time to positivity using linear and generalized linear mixed effect models.

Results: We evaluated a total of 4'118 BC bottles collected from 686 patients. A total of 1'495 (36.3%) of all bottles contained the recommended filling volume of ≥8 mL. Using a central venous and arterial catheter for drawing blood resulted in an increase of filling volume by 0.26 mL (95% CI 0.10, 0.41) and 0.50 mL (95% CI 0.31, 0.69) compared to peripheral venipuncture, respectively. Each additional nursing staff working at the time of blood drawing was associated with 6% higher odds of achieving the recommended filling volume. We found no significant correlation between the filling volume and the positivity rate.

Conclusion: Our results indicate critical pre-analytical quality markers linked to BC collection procedures to reach recommended collection volumes. No significant impact on the positivity rate was found.

Citing Articles

Effectiveness of Multimodal Intervention to Improve Blood Culture Collection in a Tertiary Care Hospital.

Kumthekar I, Urs T, Rajashekar D, Karthik K Cureus. 2024; 16(2):e53941.

PMID: 38468984 PMC: 10925844. DOI: 10.7759/cureus.53941.

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