Enhancing blood culture volume with ultrathin-wall cannula devices.

Abstract

Suboptimal blood volume collection negatively affects pathogen recovery and time to pathogen detection in clinical blood culture samples. This study evaluated the performance of the ultrathin-wall cannula device of the BD Vacutainer UltraTouch Push Button Blood Collection Set (UltraTouch; BD Life Sciences, Franklin Lakes, NJ) in increasing the blood volume collected compared to regular cannulas. In this retrospective study, the volume of blood collected in negative BD BACTEC Plus Aerobic/F Culture Vials prior to and following blind conversion to UltraTouch was measured from blood background metabolic activity signal acquired during the initial incubation period in the BD BACTEC FX instrument using a custom software application (patent pending). Differences in average fill volume between pre- and post-conversion were evaluated overall and by month. A separate logistic regression was also performed to model the relationship between monthly average blood volume increase (mL) and sample positivity rate. Prevalence rates for identified organisms were also assessed. The blood fill volume of 13,356 pre-conversion and 119,971 post-conversion bottles was compared. The average post-conversion fill volume was significantly higher than that of pre-conversion (7.56 mL [95% CI, 7.54-7.59] vs. 5.68 mL [95% CI, 5.62-5.74], respectively). This 1.88 mL increase in collected blood volume increased sample positivity from 7.0% to 7.7% (P = 0.002; odds ratio [OR], 1.11; 95% CI, 1.04-1.19). This study demonstrated that using an ultrathin-wall cannula blood collection device can significantly increase blood culture volume and sample positivity, supporting improved identification of patients suffering from bloodstream infections.IMPORTANCESubstandard blood fill volume practices in clinical settings negatively affect pathogen recovery which, in turn, may impact patients' care. Whereas professional education regarding the importance of adhering to clinical guidelines has been helpful in partly remediating the issue, the role of blood collection set technologies in optimizing blood culture volume has not been studied as thoroughly. Our study assessed the performance of the BD Vacutainer UltraTouch Push Button Blood Collection Set, which is designed with an ultrathin-wall cannula, to improve blood culture volume.