280. Performance of the SteriPath Device in Removing Skin Contamination from Blood Culture Samples
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • IDSA 2015 SPD poster final.pdf (716.2 kB)
  • Background: Contaminated blood cultures remain a challenge, often leading to unnecessary antibiotic treatment. One approach to reduce contamination is to avoid culturing the initial blood sample that can contain a contaminated plug of skin from the needle stick. Recently, a new device was developed that automatically diverts the initial 1-2mL blood so as to remove any potential skin plug with contaminants from entering the blood culture bottle. Our hypothesis was that this diverted blood should be culture positive at a rate expected in contaminated blood culture collections (e.g., 1-3%), and the accompanying blood culture would remain sterile. Therefore, we performed a pilot using the SteriPath Device (SPD) to prove our hypothesis.

    Methods: The SPD is a sterile blood collection system that diverts 1-2mL of the initial venipuncture blood into an isolated diversion chamber and then allows pure venous blood to flow into culture bottles. SPD was prospectively used to randomly collect 1 of the 2 paired culture sets from each patient. Culture was performed on diverted blood by injecting 0.5 mL Tryptic Soy Broth (TSB) into the diversion chamber and mixing it with the blood. The blood/TSB mixture was incubated for 24 hours then plated to Blood Agar. Agar plates were incubated at 35 °C and examined for 4-5 days before finalizing as negative. Identification of any isolate was performed according to standard microbiology procedures.

    Results: 108 SPD blood samples were cultured and analyzed. 2 patients were SPD diversion blood positive with coagulase negative staphylococci and routine blood culture negative, for an avoided contamination rate = 1.9% (95% CI: 0.5%-6.5%). Additionally, 2 patients were SPD diversion blood and routine blood culture positive with the same pathogen, and 5 patients were SPD diverted blood negative but routine blood culture positive with a pathogen (giving an expected frequency of bacteremia detection <50% when only 1-2mL diverted blood is cultured).

    Conclusion: Our results demonstrate that diversion of the first 1-2 mL of blood can help to lower the blood contamination rate by capturing likely skin contaminants. Assessment of SPD should approach clinical trials with the hypothesis that very low rates of contamination are achievable using diversion devices.

    Parul Patel, BS MT(ASCP), CCRP, Donna Schora, MT(ASCP), Richard Thomson Jr., PhD and Lance Peterson, MD, FIDSA, FSHEA, NorthShore University HealthSystem, Evanston, IL

    Disclosures:

    P. Patel, None

    D. Schora, None

    R. Thomson Jr., None

    L. Peterson, Magnolia: Board Member , Consulting fee and Research grant

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.