Program Schedule

Reduction in Contaminated Blood Culture Rates and Associated Costs as an Antimicrobial Stewardship Program Activity

Session: Poster Abstract Session: Antibiotic Stewardship
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • 167_IDWPOSTER.pdf (1004.9 kB)
  • Background: Contamination of blood cultures (CBCx) is a common, costly, and preventable problem which can cause confusion for clinicians and leads to unnecessary hospitalization, additional testing and consultation, and unnecessary antibiotic treatment. The maximum acceptable percent of CBCx is 3% (Clinical and Laboratory Standards, College of American Pathologist). Published studies indicate the average inpatient with a CBCx accumulated $4385 - $7502 in excess hospital costs and stayed 4.5 – 5.4 additional hospital days.

    Methods: We reviewed the CBCx occurrence from 2008-2012 and found our hospital CBCx rate exceeded the 3% rate over 32% of the time during this period.

    Results: The most common CBCx organisms were aerobic Gram-positive cocci, with the most common organism identified being S. epidermidis. Identified issues resulting in CBCx included improper skin preparation and accessing a peripheral venous catheter for blood cultures. For the years 2010-2012, the Emergency Department (ED) was responsible for 33-61%, 29-74%, and 31-76% of the monthly total CBCx, respectively. The time of day CBCx were drawn during 2010-2012 were evaluated, and CBCx occurrence rose beginning at 08:00, peaked at 14:00, and declined significantly 22:00 during these three years, nearing the staff shift change. Hospital and ED costs associated with CBCx were estimated, as well as costs incurred by the microbiology lab and pharmacy. Overall hospital cost of CBCx for the three years averaged $1,893,830, with the ED accounting for $929,500 (49%). The most commonly used antibiotic to treat CBCx was vancomycin, with an annual average hospital cost of $6,887 for the last three years evaluated. Projected hospital savings by reducing the occurrence of CBCx from the ED during these three years by 20% and 30% were $185,166 and $278,670 respectively.

    Conclusion: Reducing the occurrence of CBCx may result in significant hospital savings from inappropriate hospital admissions, additional laboratory costs, and overuse of antibiotics.

    John Toney, MD, Infectious Disease Section, James A. Haley Veterans' Hospital, Tampa, FL, Narla Fries, CLS, MT(ASCP), Pathology & Laboratory Medicine Service, James A. Haley Vaterans Hospital, Tampa, FL, Rey Rivera, MD, Infectious Disease and International Medicine, University of South Florida, Tampa, FL, Stephen Mastorides, MD, Pathology & Laboratory Medicine Service, James A. Haley Veterans Hospital, Tampa, FL, Richard Oehler, MD, FACP, FIDSA, Division of Infectious Disease and International Medicine, University of South Florida, Tampa, FL and Sandra Gompf, MD, Infectious Disease Section, James A. Haley Veterans Hospital, Tampa, FL


    J. Toney, None

    N. Fries, None

    R. Rivera, None

    S. Mastorides, None

    R. Oehler, None

    S. Gompf, None

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