Blood cultures processing after death: Best practice, cost-effective, or HAI reduction measure.

IF 2.4 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control Pub Date : 2025-08-22 DOI:10.1016/j.ajic.2025.08.014

Dixon Heather, Schafer Mathea, Amelia Cardiff, Kenneth Smith, Yassin Mohamed

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引用次数: 0

Abstract

Background: Blood cultures (BC) are essential for the diagnosis of bloodstream infections (BSI). BSI can be inaccurately attributed due to BC contamination or bacterial translocation. Reporting BCs after patient death (PD) can be inaccurate and potentially increase BSI incidence.

Methods: The study was performed in two phases, a retrospective review of positive BCs that resulted after PD and a prospective phase of discontinuing BC after PD. A cost-benefit analysis was conducted of the program considering the cost of HAIs.

Results: Retrospectively, there were 4,868 positive BC (10%) and 407 (8%) were finalized after PD. The BCs that resulted after PD and were identified as HAI included 8 CLABSI (Central Line Associated Blood Stream Infections), 11 primary and 25 secondary BSIs. During the prospective phase, the infection preventionists reviewed 795 patients and identified 285 with pending BC at the time of PD. 90.5% of these cultures were cancelled, reducing the number of potential HAI events related to BCs after PD to seven.

Conclusions: HAI rates could be falsely increased as NHSN (National Healthcare Safety Network) definitions do not address positive BC after PD. Implementing a stewardship protocol to discontinue BCs after PD is appropriate clinical practice and likely cost beneficial.

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死后血培养处理：最佳做法、成本效益或减少HAI的措施。

背景：血培养（BC）对血流感染（BSI）的诊断至关重要。BSI可能由于BC污染或细菌易位而不准确地归因于。在患者死亡后报告BSI可能不准确，并可能增加BSI的发生率。方法：研究分两期进行。一项为期三年的回顾性研究，对患者死亡（PD）后产生的所有阳性bc进行医院相关感染（HAI）的评估。在18个月的前瞻性阶段，实施PD后对未完成的BC进行并发审查，以停止BC处理。考虑到HAIs的成本，对该方案进行了成本效益分析。结果：在回顾性阶段，有4,868例BC阳性（10%），其中407例（8%）在PD后确诊。PD后产生的bc被确定为HAI，包括8例CLABSI（中央静脉相关血流感染），11例原发性和25例继发性bsi。在预期阶段，感染预防学家回顾了795名患者，并在PD时确定了285名未确诊的BC。90.5%的培养被取消，每年报告的CLABSI数量减少了31.9%。结论：由于NHSN（国家医疗安全网络）的定义没有涉及PD后阳性BC，因此HAI率可能会错误地增加。实施管理方案，在PD后停止使用bc是合适的临床实践，并且可能具有成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)