Factors associated with blood culture contamination in the emergency department

Critical illness, end-stage renal disease, and old age

Chih-Jan Chang, Chi Jung Wu, Hsiang-Chin Hsu, Chiu Hui Wu, Fang Ying Shih, Shou Wen Wang, Yi Hui Wu, Chia-Ming Chang, Yi-Fang Tu, Chih-Hsien Chi, Hsin-I Shih

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Blood culture contamination in emergency departments (ED) that experience a high volume of patients has negative impacts on optimal patient care. It is therefore important to identify risk factors associated with blood culture contamination in EDs. Methodology/Principal Findings: prospectively observational study in a university-affiliated hospital were conducted between August 2011 and December 2012. Positive monomicrobial and negative blood cultures drawn from adult patients in the ED were analyzed to evaluate the possible risk factors for contamination. A total of 1,148 positive monomicrobial cases, 391 contamination cases, and 13,689 cases of negative blood culture were identified. Compared to patients with negative blood cultures, patients in triage levels 1 and 2 (Incidence Rate Ratio, IRR = 2.24), patients with end-stage renal disease (ESRD) (IRR = 2.05), and older patients (IRR: 1.02 per year) were more likely to be associated with ED blood culture contamination. Conclusions/Significance: Critical patients (triage levels 1 and 2), ESRD patients, and older patients were more commonly associated with blood culture contamination in the ED. Further studies to evaluate whether the characteristics of skin commensals contribute to blood culture contamination is warranted, especially in hospitals populated with high-risk patients.

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Original languageEnglish
Article numbere0137653
JournalPloS one
Volume10
Issue number10
DOIs
Publication statusPublished - 2015 Oct 8

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kidney diseases
Critical Illness
Chronic Kidney Failure
Hospital Emergency Service
Contamination
Blood
blood
Triage
risk factors
Blood Culture
patient care
observational studies
Licensure
Skin
skin (animal)
Observational Studies
Reproduction
Patient Care
incidence
Incidence

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

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title = "Factors associated with blood culture contamination in the emergency department: Critical illness, end-stage renal disease, and old age",
abstract = "Background: Blood culture contamination in emergency departments (ED) that experience a high volume of patients has negative impacts on optimal patient care. It is therefore important to identify risk factors associated with blood culture contamination in EDs. Methodology/Principal Findings: prospectively observational study in a university-affiliated hospital were conducted between August 2011 and December 2012. Positive monomicrobial and negative blood cultures drawn from adult patients in the ED were analyzed to evaluate the possible risk factors for contamination. A total of 1,148 positive monomicrobial cases, 391 contamination cases, and 13,689 cases of negative blood culture were identified. Compared to patients with negative blood cultures, patients in triage levels 1 and 2 (Incidence Rate Ratio, IRR = 2.24), patients with end-stage renal disease (ESRD) (IRR = 2.05), and older patients (IRR: 1.02 per year) were more likely to be associated with ED blood culture contamination. Conclusions/Significance: Critical patients (triage levels 1 and 2), ESRD patients, and older patients were more commonly associated with blood culture contamination in the ED. Further studies to evaluate whether the characteristics of skin commensals contribute to blood culture contamination is warranted, especially in hospitals populated with high-risk patients.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",
author = "Chih-Jan Chang and Wu, {Chi Jung} and Hsiang-Chin Hsu and Wu, {Chiu Hui} and Shih, {Fang Ying} and Wang, {Shou Wen} and Wu, {Yi Hui} and Chia-Ming Chang and Yi-Fang Tu and Chih-Hsien Chi and Hsin-I Shih",
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Factors associated with blood culture contamination in the emergency department : Critical illness, end-stage renal disease, and old age. / Chang, Chih-Jan; Wu, Chi Jung; Hsu, Hsiang-Chin; Wu, Chiu Hui; Shih, Fang Ying; Wang, Shou Wen; Wu, Yi Hui; Chang, Chia-Ming; Tu, Yi-Fang; Chi, Chih-Hsien; Shih, Hsin-I.

In: PloS one, Vol. 10, No. 10, e0137653, 08.10.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors associated with blood culture contamination in the emergency department

T2 - Critical illness, end-stage renal disease, and old age

AU - Chang, Chih-Jan

AU - Wu, Chi Jung

AU - Hsu, Hsiang-Chin

AU - Wu, Chiu Hui

AU - Shih, Fang Ying

AU - Wang, Shou Wen

AU - Wu, Yi Hui

AU - Chang, Chia-Ming

AU - Tu, Yi-Fang

AU - Chi, Chih-Hsien

AU - Shih, Hsin-I

PY - 2015/10/8

Y1 - 2015/10/8

N2 - Background: Blood culture contamination in emergency departments (ED) that experience a high volume of patients has negative impacts on optimal patient care. It is therefore important to identify risk factors associated with blood culture contamination in EDs. Methodology/Principal Findings: prospectively observational study in a university-affiliated hospital were conducted between August 2011 and December 2012. Positive monomicrobial and negative blood cultures drawn from adult patients in the ED were analyzed to evaluate the possible risk factors for contamination. A total of 1,148 positive monomicrobial cases, 391 contamination cases, and 13,689 cases of negative blood culture were identified. Compared to patients with negative blood cultures, patients in triage levels 1 and 2 (Incidence Rate Ratio, IRR = 2.24), patients with end-stage renal disease (ESRD) (IRR = 2.05), and older patients (IRR: 1.02 per year) were more likely to be associated with ED blood culture contamination. Conclusions/Significance: Critical patients (triage levels 1 and 2), ESRD patients, and older patients were more commonly associated with blood culture contamination in the ED. Further studies to evaluate whether the characteristics of skin commensals contribute to blood culture contamination is warranted, especially in hospitals populated with high-risk patients.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

AB - Background: Blood culture contamination in emergency departments (ED) that experience a high volume of patients has negative impacts on optimal patient care. It is therefore important to identify risk factors associated with blood culture contamination in EDs. Methodology/Principal Findings: prospectively observational study in a university-affiliated hospital were conducted between August 2011 and December 2012. Positive monomicrobial and negative blood cultures drawn from adult patients in the ED were analyzed to evaluate the possible risk factors for contamination. A total of 1,148 positive monomicrobial cases, 391 contamination cases, and 13,689 cases of negative blood culture were identified. Compared to patients with negative blood cultures, patients in triage levels 1 and 2 (Incidence Rate Ratio, IRR = 2.24), patients with end-stage renal disease (ESRD) (IRR = 2.05), and older patients (IRR: 1.02 per year) were more likely to be associated with ED blood culture contamination. Conclusions/Significance: Critical patients (triage levels 1 and 2), ESRD patients, and older patients were more commonly associated with blood culture contamination in the ED. Further studies to evaluate whether the characteristics of skin commensals contribute to blood culture contamination is warranted, especially in hospitals populated with high-risk patients.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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