The trends of blood culture contamination and utilization rates in an LMIC tertiary care center from 2010 to 2022: a call for diagnostic stewardship?
Abstract Objective: At Saint George Hospital University Medical Center in Beirut, Lebanon, we determine (1) annual blood culture (BC) contamination (BCC) and utilization (BCU) rates vs international benchmarks, (2) identify blood culture contaminants, (3) bloodstream infections episodes in patient...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X24004790/type/journal_article |
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| author | Lama Saleh Amanda Chamieh Rima El Basst Eid Azar |
| author_facet | Lama Saleh Amanda Chamieh Rima El Basst Eid Azar |
| author_sort | Lama Saleh |
| collection | DOAJ |
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Abstract
Objective:
At Saint George Hospital University Medical Center in Beirut, Lebanon, we determine (1) annual blood culture (BC) contamination (BCC) and utilization (BCU) rates vs international benchmarks, (2) identify blood culture contaminants, (3) bloodstream infections episodes in patients with and without COVID-19 after the pandemic onset, and (4) any epidemiologic trends in BCC and BCU.
Design:
Retrospective observational study.
Setting:
Private tertiary referral center, from January 1, 2010, to December 31, 2022.
Methods:
We define a contaminated BC as the growth of a typical contaminant/skin flora in 1-2/4 BC bottles. We calculate BCC rates as a percentage of the contaminated BC/total BC during the period and BCU rates as the number of BC/1000 patient days (PD).
Results:
The average BCU rate of 85.9/1000 PD in 2010–2019 increased to 106.6/1000 PD in 2020–2022. On average, patients with COVID-19 had a higher BCU rate of 185.9/1000 PD, corresponding to an additional 100 blood cultures/1000 PD. The average BCC rate was 7%, ranging from 6% in 2010–2019 to 8% in 2020–2022. We observed the highest BCC rate of 9% in patients with COVID-19, likely due to the higher BCU. The most frequently isolated contaminants were coagulase-negative Staphylococcus (96%), of which 65% were Staphylococcus epidermidis.
Conclusion:
We saw a multifactorial, persistently elevated rate of BCC over 13 years as unaffected by strict infection control practices. We think that further research targeting a standardized, low BCU rather than inevitable BCC while advocating for diagnostic stewardship of low-middle-income countries is essential, especially where the lack of appropriate resource allocation and awareness are problematic.
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| format | Article |
| id | doaj-art-b9faa8d6b6864eb3af21eace4c61f076 |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-b9faa8d6b6864eb3af21eace4c61f0762025-01-27T10:12:27ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2024.479The trends of blood culture contamination and utilization rates in an LMIC tertiary care center from 2010 to 2022: a call for diagnostic stewardship?Lama Saleh0https://orcid.org/0009-0007-5718-206XAmanda Chamieh1https://orcid.org/0000-0002-6158-8747Rima El Basst2Eid Azar3https://orcid.org/0000-0002-8368-2670Department of Infectious Diseases, Saint George Hospital University Medical Center, Beirut, LebanonDepartment of Infectious Diseases, Saint George Hospital University Medical Center, Beirut, Lebanon Department of Infection Prevention and Control and Antimicrobial Stewardship, Saint George Hospital University Medical Center, Beirut, LebanonDepartment of Infection Prevention and Control and Antimicrobial Stewardship, Saint George Hospital University Medical Center, Beirut, LebanonDepartment of Infectious Diseases, Saint George Hospital University Medical Center, Beirut, Lebanon Department of Infection Prevention and Control and Antimicrobial Stewardship, Saint George Hospital University Medical Center, Beirut, Lebanon Abstract Objective: At Saint George Hospital University Medical Center in Beirut, Lebanon, we determine (1) annual blood culture (BC) contamination (BCC) and utilization (BCU) rates vs international benchmarks, (2) identify blood culture contaminants, (3) bloodstream infections episodes in patients with and without COVID-19 after the pandemic onset, and (4) any epidemiologic trends in BCC and BCU. Design: Retrospective observational study. Setting: Private tertiary referral center, from January 1, 2010, to December 31, 2022. Methods: We define a contaminated BC as the growth of a typical contaminant/skin flora in 1-2/4 BC bottles. We calculate BCC rates as a percentage of the contaminated BC/total BC during the period and BCU rates as the number of BC/1000 patient days (PD). Results: The average BCU rate of 85.9/1000 PD in 2010–2019 increased to 106.6/1000 PD in 2020–2022. On average, patients with COVID-19 had a higher BCU rate of 185.9/1000 PD, corresponding to an additional 100 blood cultures/1000 PD. The average BCC rate was 7%, ranging from 6% in 2010–2019 to 8% in 2020–2022. We observed the highest BCC rate of 9% in patients with COVID-19, likely due to the higher BCU. The most frequently isolated contaminants were coagulase-negative Staphylococcus (96%), of which 65% were Staphylococcus epidermidis. Conclusion: We saw a multifactorial, persistently elevated rate of BCC over 13 years as unaffected by strict infection control practices. We think that further research targeting a standardized, low BCU rather than inevitable BCC while advocating for diagnostic stewardship of low-middle-income countries is essential, especially where the lack of appropriate resource allocation and awareness are problematic. https://www.cambridge.org/core/product/identifier/S2732494X24004790/type/journal_article |
| spellingShingle | Lama Saleh Amanda Chamieh Rima El Basst Eid Azar The trends of blood culture contamination and utilization rates in an LMIC tertiary care center from 2010 to 2022: a call for diagnostic stewardship? Antimicrobial Stewardship & Healthcare Epidemiology |
| title | The trends of blood culture contamination and utilization rates in an LMIC tertiary care center from 2010 to 2022: a call for diagnostic stewardship? |
| title_full | The trends of blood culture contamination and utilization rates in an LMIC tertiary care center from 2010 to 2022: a call for diagnostic stewardship? |
| title_fullStr | The trends of blood culture contamination and utilization rates in an LMIC tertiary care center from 2010 to 2022: a call for diagnostic stewardship? |
| title_full_unstemmed | The trends of blood culture contamination and utilization rates in an LMIC tertiary care center from 2010 to 2022: a call for diagnostic stewardship? |
| title_short | The trends of blood culture contamination and utilization rates in an LMIC tertiary care center from 2010 to 2022: a call for diagnostic stewardship? |
| title_sort | trends of blood culture contamination and utilization rates in an lmic tertiary care center from 2010 to 2022 a call for diagnostic stewardship |
| url | https://www.cambridge.org/core/product/identifier/S2732494X24004790/type/journal_article |
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