Best solution to reduce blood culture contamination


Intravenous literature: Marlowe, L., Mistry, R.D., Coffin, S., Leckerman, K.H., McGowan, K.L., Dai, D., Bell, L.M. and Zaoutis, T. (2009) Blood Culture Contamination Rates after Skin Antisepsis with Chlorhexidine Gluconate versus Povidone-Iodine in a Pediatric Emergency Department. Infection Control & Hospital Epidemiology, 31 (click here for the abstract).


Objective – To determine blood culture contamination rates after skin antisepsis with chlorhexidine, compared with povidone‐iodine.

Design – Retrospective, quasi‐experimental study.

Setting – Emergency department of a tertiary care children’s hospital.

Patients – Children aged 2-36 months with peripheral blood culture results from February 2004 to June 2008. Control patients were children younger than 2 months with peripheral blood culture results.

Methods. Blood culture contamination rates were compared using segmented regression analysis of time‐series data among 3 patient groups: (1) patients aged 2-36 months during the 26 month preintervention period, in which 10% povidone‐iodine was used for skin antisepsis before blood culture; (2) patients aged 2-36 months during the 26 month postintervention period, in which 3% chlorhexidine gluconate was used; and (3) patients younger than 2 months not exposed to the chlorhexidine intervention (ie, the control group).

Results – Results from 11,595 eligible blood cultures were reviewed (4,942 from the preintervention group, 4,274 from the postintervention group, and 2,379 from the control group). For children aged 2-36 months, the blood culture contamination rate decreased from 24.81 to 17.19 contaminated cultures per 1,000 cultures (P< .05) after implementation of chlorhexidine. This decrease of 7.62 contaminated cultures per 1,000 cultures (95% confidence interval, −0.781 to −15.16) represented a 30% relative decrease from the preintervention period and was sustained over the entire postintervention period. No change in contamination rate was observed in the control group (P=.337).

Conclusion – Skin antisepsis with chlorhexidine significantly reduces the blood culture contamination rate among young children, as compared with povidone-iodine.


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