Blood Culture Contamination in a Busy Emergency Ward of a Tertiary Care Hospital in Kolkata

Introduction: Blood culture contamination (BCC) is a serious clinical problem which leads to consequences like initiation or prolongation of antibiotic therapy, complications associated with antibiotic use and prolongation of hospital stay adding to healthcare expenses etc. BCC occurs mostly during sample collection. A Survey of blood collection technique in hospital showed that blood culture sample collection into BACT ALERT bottles by plain syringes results in multiple surface contact thereby increasing contamination rate. To overcome this problem a set of new blood culture vacutainer holder was introduced so that blood could directly be collected into blood culture bottles without any intermediate contact. This audit was done to objectively evaluate whether introduction of this device reduces BCC rates in a hospital. Methods: Data of BCC rate in blood culture samples collected in emergency was assessed for 1 month period before and after introduction of new blood culture holders. Results: BCC rate before and after introduction of new holders were 25.33% and 9.57% respectively. The results thus demonstrated a 62.21% reduction in blood culture contamination rate. Chi Square test showed a significant reduction of BCC rate after this improvisation of sample collection technique. (p value 0.001) Conclusion: Introduction of the improvised blood culture collection technique with special holder objectively reduced BCC rates without any significant increase in cost. Findings of this clinical audit instils hope that the wider usage of this device can bring down BCC rates significantly, while at the same time ensuring convenience of collection and increasing needle safety. Keywords: Blood Culture Contamination, contaminants, Vacutainer holder .