Effects of COVID-19 on Blood Culture Contamination at a Tertiary Care Academic Medical Center.

Brianna Sacchetti, Justin Travis, Lisa L Steed, Ginny Webb
Author Information
  1. Brianna Sacchetti: Division of Natural Sciences and Engineering, University of South Carolina Upstate, Spartanburg, South Carolina, USA.
  2. Justin Travis: Department of Psychology, University of South Carolina Upstate, Spartanburg, South Carolina, USA. ORCID
  3. Lisa L Steed: Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
  4. Ginny Webb: Division of Natural Sciences and Engineering, University of South Carolina Upstate, Spartanburg, South Carolina, USA. ORCID

Abstract

The COVID-19 pandemic has changed health care, from increased needs of personal protective equipment (PPE) to overloaded staff and influxes of patients. Blood cultures are frequently used to detect bloodstream infections in critically ill patients, but it is unknown whether the COVID-19 pandemic has had an impact on blood culture contamination rates. A total of 88,332 blood cultures taken over a 33-month period were analyzed to compare blood culture contamination rates before the COVID-19 pandemic to rates during the pandemic. A significant increase in the average number of monthly nurse-drawn and peripherally collected cultures occurred after the start of the pandemic, but there was a decrease in the average number of phlebotomy cultures. A significant increase in contamination rates ( < 0.001) was found in all nonemergency hospital departments during the COVID-19 pandemic, increasing from 2.1% to 2.5%. Increased rates during the COVID-19 pandemic were also found for nursing staff (2.0% to 2.4%) and both peripheral (2.1% to 2.5%) and indwelling line draws (1.1% to 1.7). The number of cultures drawn monthly increased in acute adult departments and both adult and pediatric emergency departments. Blood culture contamination rates in adult acute, adult emergency, and pediatric intensive care units increased after the start of the pandemic by 23%, 75%, and 59%, respectively. A positive correlation was found between blood culture contamination rates and COVID-19 incidence rates. Additional periodic staff training on proper blood collection technique and awareness of the workload of health care workers are recommended to decrease contamination rates during the COVID-19 pandemic. Understanding factors that contribute to blood culture contamination is important in order to take steps to limit contamination events. Here, we examine the effect the COVID-19 pandemic has had on blood culture contamination rates and specifically detail the effects based on the staff, draw types, and unit types. The conclusions provided here can be used as hospitals and laboratories navigate the COVID-19 pandemic or other times of high patient volume.

Keywords

References

  1. PLoS One. 2020 Aug 7;15(8):e0237303 [PMID: 32764825]
  2. Infect Control Hosp Epidemiol. 2022 Jan;43(1):26-31 [PMID: 33602361]
  3. Clin Microbiol Infect. 2006 Aug;12(8):818-21 [PMID: 16842584]
  4. Infect Dis (Lond). 2021 Feb;53(2):145-147 [PMID: 33131375]
  5. J Med Virol. 2021 Jan;93(1):250-256 [PMID: 32592501]
  6. Infect Control Hosp Epidemiol. 2011 Jun;32(6):623-5 [PMID: 21558778]
  7. Clin Microbiol Infect. 2018 Sep;24(9):964-969 [PMID: 29621616]
  8. Crit Rev Clin Lab Sci. 2020 Sep;57(6):365-388 [PMID: 32645276]
  9. Am J Pathol. 2007 May;170(5):1435-44 [PMID: 17456750]
  10. MMWR Morb Mortal Wkly Rep. 2020 Jun 12;69(23):699-704 [PMID: 32525856]
  11. Lancet. 2020 May 2;395(10234):e79-e80 [PMID: 32334649]
  12. Ann Emerg Med. 2020 Nov;76(5):595-601 [PMID: 33008651]
  13. PLoS One. 2021 Feb 3;16(2):e0246548 [PMID: 33534870]
  14. Am J Emerg Med. 2012 Jul;30(6):839-45 [PMID: 22169577]
  15. Blood. 2014 Jul 10;124(2):188-95 [PMID: 24876563]
  16. Am J Emerg Med. 2020 Sep;38(9):1732-1736 [PMID: 32738468]
  17. Health Serv Res. 2009 Apr;44(2 Pt 1):422-43 [PMID: 19207589]
  18. BMC Infect Dis. 2021 Feb 22;21(1):199 [PMID: 33618663]
  19. Crit Care Med. 2001 Jul;29(7):1303-10 [PMID: 11445675]
  20. Am J Emerg Med. 2021 Aug;46:476-481 [PMID: 33189517]
  21. Cardiovasc Intervent Radiol. 2020 Jun;43(6):810-819 [PMID: 32342164]
  22. J Emerg Nurs. 2013 Jan;39(1):e1-6 [PMID: 23295096]
  23. Hastings Cent Rep. 2020 May;50(3):35-39 [PMID: 32410225]
  24. Infect Control Hosp Epidemiol. 2021 Aug;42(8):997-1000 [PMID: 33213553]
  25. PLoS One. 2020 Nov 23;15(11):e0242533 [PMID: 33226995]
  26. Anaesthesia. 2020 Aug;75(8):1105-1113 [PMID: 32339260]
  27. JAMA Health Forum. 2020 Mar 2;1(3):e200345 [PMID: 36218595]
  28. JAMA Pediatr. 2020 Sep 01;174(9):868-873 [PMID: 32392288]
  29. J Clin Microbiol. 2020 Jul 23;58(8): [PMID: 32404482]
  30. Circulation. 2020 Nov 3;142(18):1791-1793 [PMID: 32966752]
  31. JAMA Netw Open. 2021 Feb 1;4(2):e2037227 [PMID: 33576819]
  32. Nat Commun. 2021 Mar 26;12(1):1904 [PMID: 33771988]
  33. Arch Pathol Lab Med. 1996 Nov;120(11):999-1002 [PMID: 12049115]

Grants

  1. P20 GM103499/NIGMS NIH HHS

MeSH Term

Academic Medical Centers
Adult
Blood Culture
COVID-19
Child
Humans
Pandemics
Tertiary Healthcare

Word Cloud

Created with Highcharts 10.0.0COVID-19pandemiccontaminationratesbloodculture2culturesstaffadultcareincreasedBloodnumberfounddepartments1%healthpatientsusedsignificantincreaseaveragemonthlystartdecreasephlebotomy5%nursing1acutepediatricemergencytypeschangedneedspersonalprotectiveequipmentPPEoverloadedinfluxesfrequentlydetectbloodstreaminfectionscriticallyillunknownwhetherimpacttotal88332taken33-monthperiodanalyzedcomparenurse-drawnperipherallycollectedoccurred< 0001nonemergencyhospitalincreasingIncreasedalso0%4%peripheralindwellinglinedraws7drawnintensiveunits23%75%59%respectivelypositivecorrelationincidenceAdditionalperiodictrainingpropercollectiontechniqueawarenessworkloadworkersrecommendedUnderstandingfactorscontributeimportantordertakestepslimiteventsexamineeffectspecificallydetaileffectsbaseddrawunitconclusionsprovidedcanhospitalslaboratoriesnavigatetimeshighpatientvolumeEffectsCultureContaminationTertiaryCareAcademicMedicalCenter

Similar Articles

Cited By