Authors (including presenting author) :
Leung WCC(1), Chen CP(1), Chu HC(1), Chan NY(1), Mok WS(1), Tsang YM(1), Luk SK(1), To WK(1), Lai WM(2), Yu WS(2), Tao WL(2)
Affiliation :
(1)Infection Control Team, Yan Chai Hospital, (2)Clinical Support Unit, Yan Chai Hospital
Introduction :
Blood culture testing is the gold standard for diagnosing bloodstream infections, and accurate results are essential for delivering safe, timely, and effective care. However, blood culture contamination can lead to unnecessary antibiotic use, prolonged hospital stays, and increased healthcare costs. Prior to 2008, the blood culture contamination rate at Yan Chai Hospital (YCH) exceeded 4%, significantly higher than the international standard of 3%. Recent guidelines have further tightened the target to less than 1% when best practices are implemented.
Objectives :
The program aimed to reduce blood culture contamination rates at YCH below the international standard through a comprehensive and multi-faceted intervention strategy initiated in 2008.
Methodology :
A bundle of interventions was introduced in 2008 to address blood culture contamination. Key measures included revising the blood culture collection protocol, improving skin antisepsis techniques prior to blood collection, and recruiting dedicated phlebotomists for blood culture sampling. Newly recruited phlebotomists were assessed by the infection control team to ensure adherence to proper techniques. A feedback mechanism was implemented to provide real-time notifications to phlebotomists in cases of contaminated cultures, along with regular performance reports for phlebotomists and their supervisors. The blood culture contamination rate was monitored annually from 2008 to 2023, and regression analysis was conducted to evaluate trends over this period.
Result & Outcome :
Following the program's implementation in 2008, the blood culture contamination rate dropped significantly, from 2.4% in 2008 to less than 0.1% in 2023, with an average annual reduction of 0.1% (p<0.001, R²=0.64). By 2011, the contamination rate had fallen below the 1% international target and has consistently remained well below this benchmark. These sustained improvements highlight the success of the interventions, including enhanced training, standardized sampling techniques, and a robust monitoring and feedback system.
