Magnolia Medical Technologies, inventor of the Steripath Initial Specimen Diversion Device (ISDD), an FDA 510(k)-cleared device platform designed to reduce blood culture contamination for sepsis testing accuracy1, shared a study detailing the clinical and financial impacts of blood culture contamination on patient safety.
The clinical results were published by the University of Arkansas for Medical Sciences (UAMS) Medical Center in Little Rock, Arkansas. This four-year retrospective analysis examined the clinical and financial impacts of blood culture contamination on patient safety, outcomes, and in-hospital patient mortality.
Blood cultures are the gold standard diagnostic test for detecting blood stream infections, including sepsis, the company says. It is one of the most frequently performed diagnostic tests in U.S. hospitals with an estimated 58 million tests each year. However, positive results from these tests are frequently wrong, with approximately 40% of positive results returning a false-positive result due to contamination.
These false-positive results can lead to the misdiagnosis of sepsis and subject the patient to unnecessary, prolonged, and harmful broad-spectrum antibiotic treatment and unnecessary extended length of in-patient hospital stay. This in turn increases the risk for acute kidney injury, clostridioides difficile infection, multidrug-resistant organism infections, other hospital-acquired infections, and significant avoidable hospital costs.
Blood Culture Contamination Study
The study, entitled “Risk factors and clinical outcomes associated with blood culture contamination“, published in the peer-reviewed medical journal Infection Control & Hospital Epidemiology, specifically compared clinical outcomes for patients with contaminated blood cultures (cases) against the clinical outcome of patients with negative blood cultures (controls) for inpatients with blood cultures collected in the Emergency Department (ED) from 2014 to 2018.
Based on their four-year retrospective analysis, researchers reported that after controlling for age, race, Body Mass Index (BMI), comorbidities, and sepsis, blood culture contamination increased vancomycin days of therapy by 40%, the risk of acute kidney injury by 40% as well, and lengthened patient hospital stay by 24%. The most alarming finding, however, was the significant, near doubling of in-hospital patient mortality rate—from a 4.6%in-hospital patient mortality rate for patients in the true negative blood culture control group to an 8% in-hospital patient mortality rate for patients that had contaminated cultures.
“Blood culture contamination is an underrecognized adverse event in hospitalized patients that increases negative clinical outcomes by directly placing our patients at unnecessary risk,” says Ryan K. Dare, MD, co-author and associate professor of medicine, infectious diseases specialist, and Medical Director of the Antimicrobial Stewardship Program at University of Arkansas for Medical Sciences Health. “It is imperative for hospital systems to make decreasing blood culture contamination a priority to improve safety for patients under our care. Sterile technique for blood culture collection remains difficult to achieve in high-risk individuals and in high-risk settings such as emergency departments. Access to an initial specimen diversion device that is user friendly, cost effective, and successful at decreasing rates of contamination represents a game changer for patient safety and opportunity to dramatically improve patient outcomes.”
The study concluded that the contamination can have “devastating clinical consequences for patients” including “increased length of stay, vancomycin days of therapy, hospital costs, acute kidney injury, and in-hospital patient mortality.” Given these findings, the researchers emphasized the importance of mitigating unnecessary. culture contamination with novel interventions and a culture of quality change to reduce the negative burden of this essential diagnostic test.
“This study includes one of the largest data sets to date examining and directly quantifying the preventable consequences of blood culture contamination on patient safety and clinical outcomes,” says Greg Bullington, CEO and co-founder of Magnolia Medical.