Blood culture contamination in the Department of Paediatrics of Universitas- and Pelonomi Hospitals
Loading...
Date
2020-08
Authors
Krause, R. C.
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
Background: Sepsis and septic shock are one of the most important risk factors for mortality in children. Blood cultures remain the gold standard to identify the causative organisms of sepsis and to obtain the antibiotic sensitivity profile. The shortcoming of blood cultures is that only 5 to 13% of cultures will turn out to be positive and roughly 20 to 56% of these will represent contaminants. The South African Society for Clinical Microbiology (SASCM) endorses the blood culture sampling technique as described by Ntusi e t al . (2010). Abrahams et al . (2015) described that there was poor adherence to these standards which contributes to a high blood culture contamination rate. There is a shortage of South African studies addressing the problem of blood culture contamination. Objective: To determine the blood culture contamination rates in the Department of Paediatrics at Pelonomi- and Universitas Hospital for the month of May to 27 August 2019 by reviewing blood culture results. To assess blood culture sampling technique amongst clinicians by means of anonymous questionnaires. Methods: This is a descriptive study. The blood culture contamination rate for 1 May 2019 to 27 August 2019 was determined by analysing NHLS data. Clinician blood culture sampling practices were described by using information from anonymous questionnaires which were handed out to clinicians working in the Department of Paediatrics during the same period. Results: Of the 244 blood cultures reviewed, 61 (25%) had positive growth, 36 (15%) grew contaminants and 7 (3%) grew more than one organism. The blood culture contamination rate was 15%. Thirty-two percent of clinicians were aware of the SASCM guidelines regarding blood culture sampling technique, but only 3% indicated that they complied with the guidelines. Conclusion: This study found a blood culture contamination rate which is almost five times higher than internationally accepted rate. It also found that clinicians were not aware of blood culture sampling guidelines and in the few cases where clinicians were aware of these guidelines, compliance with these guidelines was not met. Recommendations made, include quarterly review of blood culture contamination rate at these institutions and making clinicians aware of correct technique or optimising technique within the limited circumstances by putting together guidelines on blood sampling techniques for blood cultures for local use.
Description
Keywords
Dissertation (M.Med. (Paediatrics and Child Health))--University of the Free State, 2020, Sepsis, Blood culture, Paediatric sepsis, Blood culture contamination rates, Blood culture contaminants