ID WEEK 2016 POSTER ABSTRACTS 164. Initial Specimen Diversion Device Prevents Blood Culture Contamination Mark E. Rupp, MD, FIDSA, FSHEA1; R. Jennifer Cavalieri, RN2; Cole Marolf, Medical Student3; Elizabeth Lyden, MS4; 1Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska; 2Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska; 3University of Nebraska Medical Center, Omaha, Nebraska; 4College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
compare proportions of contaminated and true-positive blood cultures. Fisher’s exact test was used to examine the association between phlebotomists and contamination rate. Results. Nine hundred seventy-one subjects were enrolled resulting in 904 nonduplicative patients with 1808 blood cultures. Ninety-six of 1808 (5.3%) blood cultures yielded microbial growth with 79 of 1808 (4.4%) regarded as true infections and 18 of 1808 (1%) contaminants. The ISDD was associated with less blood culture contamination compared with SLP (2 of 904 [0.22%] versus 16 of 904 [1.78%]; P = 0.001). There was no association between phlebotomist and contamination using SLP (P = 0.31) or ISDD (P = 0.62). Sensitivity was not compromised: true bacteremia was noted in 65 of 904 (7.2%) with ISDD and 69 of 904 (7.6%) with SLP (P = 0.41) (figure).
Session: 47. Diagnostics: Bacteremia Thursday, October 27, 2016: 12:30 PM Background. Contamination of blood cultures and resultant false-positive results are common and cause unnecessary antibiotic therapy, additional laboratory testing, and excess healthcare costs. Skin microbes that are not eradicated by antiseptics result in contamination at the time of phlebotomy. This study tested the effectiveness of a device designed to limit blood culture contamination through diversion and sequestration of the initial 1.5–2.0 mL blood. Methods. This was a single center, prospective, open-label, controlled trial, conducted from November 2014 to October 2015, of an initial specimen diversion device ([ISDD] SteriPath, Magnolia) in adults in an emergency department. Select subjects granting consent had paired blood cultures performed by trained phlebotomists via peripheral venipuncture (one culture was obtained using standard laboratory procedures [SLP], the other using ISDD). Blood cultures were monitored, and microbes were characterized using routine institutional clinical microbiology protocols. A standard definition of contamination was used. McNemar’s test was used to
Conclusion. Use of the ISDD resulted in a significant reduction in contamination of blood cultures, without an impact on sensitivity, in adult patients in an emergency department setting. A reduction in blood culture contamination may decrease unnecessary antimicrobial usage, result in cost savings, and improved patient outcomes. Disclosures. M. E. Rupp, Magnolia Medical Technologies: Grant Investigator, Research grant
Some abstract images in the OFID IDWeek 2016 Abstract Supplement may be unclear. In those instances, it is recommended that you use the IDWeek Interactive Program Planner to view the abstract and images. The Program Planner can be found here: https://idsa.confex.com/idsa/2016/webprogram/start.html. Open Forum Infectious Diseases 2016;1(S1):S1–285 © The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/ by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact
[email protected]. DOI: 10.1093/ofid/ofw172
Poster Abstracts
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