Prevention of Blood Culture Contamination CPG Synopsis-Prevention of Blood Culture Contamination CPG Synopsis

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Blood culture contamination, or false positive blood cultures, is a common problem in hospitals. This contamination occurs when organisms that are not present in the blood are grown in culture. Blood cultures are crucial for diagnosing serious infections and guiding treatment decisions, but contamination limits their prognostic value and can lead to unnecessary antibiotic use and additional tests. This clinical practice guideline aims to prevent blood culture contamination during the pre-analytic phase. <br /><br />The guideline provides recommendations for various interventions to decrease contamination rates. Some of the recommendations include diverting the initial 1-2 ml of blood into a sterile receptacle, using a standard sterile process to draw blood cultures, drawing cultures from a dedicated peripheral venipuncture site, and using pre-assembled blood culture collection packs. <br /><br />Education and training for personnel who collect blood cultures is recommended, along with monitoring contamination rates and providing performance feedback. It is also suggested to establish a dedicated staff for drawing blood cultures. <br /><br />Regarding skin preparation, the guideline suggests allowing the skin cleansing agent to air dry before venipuncture, using chlorhexidine alcohol to clean the skin in patients over 2 months of age, and using products containing alcohol to cleanse the skin before collecting blood cultures. Alcohol should also be used to clean the skin in children under 2 months of age. <br /><br />The use of routine sterile gloves and cleaning blood culture bottle tops with 70% isopropyl alcohol are other recommended interventions. However, there is insufficient evidence to recommend routine sterile gloves or provide specific guidance on blood sample volume and specimen collection from intravenous catheters. <br /><br />Diversion devices and the double needle technique for inoculating the blood culture bottle are suggested to reduce contamination rates. However, changing needles is not recommended due to the risk of blood exposure. <br /><br />These recommendations vary in their level of evidence, with Level A indicating high-quality evidence and Level C indicating limited or low-quality evidence. Overall, this guideline aims to improve the accuracy and reliability of blood cultures by minimizing contamination rates.

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Keywords

blood culture contamination

false positive blood cultures

hospitals

diagnosing infections

antibiotic use

pre-analytic phase

venipuncture site

skin preparation

routine sterile gloves

diversion devices