{"title":"Increased incidence of blood culture contaminations during and after the COVID-19 pandemic.","authors":"Hannah Tolle, Aude Nguyen, Aleece MacPhail, Nasreen Hassoun-Kheir, Marie-Noelle Chraiti, Filippo Boroli, Marie-Céline Zanella, Stephan Harbarth, Gaud Catho, Niccolò Buetti","doi":"10.1007/s15010-024-02469-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Blood culture contamination (BCC) is mainly caused by commensal bacteria, during sample collection. It results in unnecessary antibiotic exposure, prolonged hospitalisation, additional microbiology workup and significant adverse health-economic burden. We aimed to investigate the short- and long-term impact of the COVID-19 pandemic on the incidence of BCC.</p><p><strong>Methods: </strong>We conducted a retrospective, observational cohort study at Geneva University Hospitals (HUG). We included all BCCs from January 2018 to December 2023, collected as part of a prospective hospital-wide surveillance by the infection control team. Data were analyzed using segmented Poisson regression models to evaluate BCC incidence rate ratios (IRRs) across three periods: pre-COVID-19 (2018-2019), during COVID-19 (2020-2021), and post-COVID-19 peak (2022-2023).</p><p><strong>Results: </strong>Out of 456,873 collected blood cultures, 1,247 BCCs were identified (0.27%). The contamination rate per 1000 samples increased from 1.53 pre-COVID-19 to 2.94 during COVID-19 and 3.52 post-COVID-19. Compared to the pre-COVID-period, incidence rate ratios (IRRs) for BCC increased during COVID-19 (IRR 1.84, 95% CI 1.58-2.15) and post-COVID-19 peak (IRR 2.29, 95% CI 1.97-2.66). During COVID-19, proportions of BCC were increased in intensive care units (27.4%, n = 127) and returned to baseline level post-COVID-19 (17.3%, n = 93, p < 0.001); whereas, in other wards, BCC remained elevated (42.2%, n = 227) in the post-COVID-19 period.</p><p><strong>Conclusions: </strong>We observed a significant rise in BCC incidence during and after the COVID-19 peak. The persistently elevated post-peak rates highlight ongoing challenges in regaining optimal aseptic blood culture collection practices and the need for further exploration of persisting factors increasing BCC rates.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s15010-024-02469-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Blood culture contamination (BCC) is mainly caused by commensal bacteria, during sample collection. It results in unnecessary antibiotic exposure, prolonged hospitalisation, additional microbiology workup and significant adverse health-economic burden. We aimed to investigate the short- and long-term impact of the COVID-19 pandemic on the incidence of BCC.
Methods: We conducted a retrospective, observational cohort study at Geneva University Hospitals (HUG). We included all BCCs from January 2018 to December 2023, collected as part of a prospective hospital-wide surveillance by the infection control team. Data were analyzed using segmented Poisson regression models to evaluate BCC incidence rate ratios (IRRs) across three periods: pre-COVID-19 (2018-2019), during COVID-19 (2020-2021), and post-COVID-19 peak (2022-2023).
Results: Out of 456,873 collected blood cultures, 1,247 BCCs were identified (0.27%). The contamination rate per 1000 samples increased from 1.53 pre-COVID-19 to 2.94 during COVID-19 and 3.52 post-COVID-19. Compared to the pre-COVID-period, incidence rate ratios (IRRs) for BCC increased during COVID-19 (IRR 1.84, 95% CI 1.58-2.15) and post-COVID-19 peak (IRR 2.29, 95% CI 1.97-2.66). During COVID-19, proportions of BCC were increased in intensive care units (27.4%, n = 127) and returned to baseline level post-COVID-19 (17.3%, n = 93, p < 0.001); whereas, in other wards, BCC remained elevated (42.2%, n = 227) in the post-COVID-19 period.
Conclusions: We observed a significant rise in BCC incidence during and after the COVID-19 peak. The persistently elevated post-peak rates highlight ongoing challenges in regaining optimal aseptic blood culture collection practices and the need for further exploration of persisting factors increasing BCC rates.
期刊介绍:
Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings.
The journal covers a wide range of topics, including:
Etiology: The study of the causes of infectious diseases.
Pathogenesis: The process by which an infectious agent causes disease.
Diagnosis: The methods and techniques used to identify infectious diseases.
Treatment: The medical interventions and strategies employed to treat infectious diseases.
Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies.
Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections.
In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.