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Clinical outcomes associated with blood-culture contamination are not affected by utilization of a rapid blood-culture identification system

Published online by Cambridge University Press:  20 March 2023

Sidra Liaquat Khan ,
Gleb Haynatzki ,
Sharon J. Medcalf Open the ORCID record for Sharon J. Medcalf [Opens in a new window]  and
Mark E. Rupp Open the ORCID record for Mark E. Rupp [Opens in a new window]
Sidra Liaquat Khan
Affiliation:
Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
Gleb Haynatzki
Affiliation:
Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
Sharon J. Medcalf
Affiliation:
Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
Mark E. Rupp*
Affiliation:
Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
*
Author for correspondence: Mark E. Rupp, E-mail: merupp@unmc.edu
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Abstract

Objective:

Contaminated blood cultures result in extended hospital stays and extended durations of antibiotic therapy. Rapid molecular-based blood culture testing can speed positive culture detection and improve clinical outcomes, particularly when combined with an antimicrobial stewardship program. We investigated the impact of a multiplex polymerase chain reaction (PCR) FilmArray Blood Culture Identification (BCID) system on clinical outcomes associated with contaminated blood cultures.

Methods:

We conducted a retrospective cohort study involving secondary data analysis at a single institution. In this before-and-after study, patients with contaminated blood cultures in the period before PCR BCID was implemented (ie, the pre-PCR period; n = 305) were compared to patients with contaminated blood cultures during the period after PCR BCID was implemented (ie, the post-PCR implementation period; n = 464). The primary exposure was PCR status and the main outcomes of the study were length of hospital stay and days of antibiotic therapy.

Results:

We did not detect a significant difference in adjusted mean length of hospital stay before (10.8 days; 95% confidence interval [CI], 9.8–11.9) and after (11.2 days; 95% CI, 10.2–12.3) the implementation of the rapid BCID panel in patients with contaminated blood cultures (P = .413). Likewise, adjusted mean days of antibiotic therapy between patients in pre-PCR group (5.1 days; 95% CI, 4.5–5.7) did not significantly differ from patients in post-PCR group (5.3 days; 95% CI, 4.8–5.9; P = .543).

Conclusion:

The introduction of a rapid PCR-based blood culture identification system did not improve clinical outcomes, such as length of hospital stay and duration of antibiotic therapy, in patients with contaminated blood cultures.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 10 , October 2023 , pp. 1569 - 1575
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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