Background Patients who come to the emergency room or inhospital patients diagnosed with sepsis as part of the septic workup need a blood culture. Blood cultures should be done by trained individuals, such as physicians or phlebotomists, under sterile conditions to prevent contamination.
Objective To find out the source and location of the contamination with the purpose of educating the hospital staff in regard to sterile blood culture techniques. To estimate the burden due to increased length of hospital stay and the cost incurred.
Method Prospective study carried out in a community-based hospital with a fully functional emergency department and a residency program. When drawing the blood for cultures, the staff had to fill out a form stating the date, patient's name, indication for blood cultures, site of the blood drawn, and the name of the person who drew the blood. If there was a contamination, the microbiology department informed the responsible staff member and took corrective measures.
Results 146 contaminated blood samples were reported during a period of 6 months. Ninety-five percent of the contaminations were due to skin commensals; 44.8% of the contaminations occurred in regular floors, 36.67% in the ER, 9% in MICU, and 9.5% in SICU. Whereas 52% of the contaminations were due to blood drawn by the emergency room physicians, 36% were drawn by phlebotomist and 12% by residents. The patients had to spend an additional 5.63 days on average, with an added cost of 16,890 dollars for further workup due to contaminated blood cultures.
Conclusion If the technique is not proper, contamination can occur in any location and anybody can be responsible for the contamination. The hospital should have strict policies in sterile blood culture techniques and frequent education of the staff, which will definitely help as a cost-cutting method.
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