Nationwide Survey of Blood Culture Performance Regarding Skin Disinfection, Blood Collection and Laboratory Procedure
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Background: Although many laboratories use automated blood culture systems, adequate skin disinfection and optimal blood volume are still critical for successful culture. The authors undertook a nationwide survey to understand the current situation and problems of blood culture in Korea. Methods: A survey of blood culture was performed in March and April 2010, including disinfectants, blood collection intervals, and recommended blood volumes. The laboratory physicians described the storage condition of culture bottles before delivery to the equipment. For quality control, the positive rate and skin contamination rate were enlisted. Results: Replies to the survey were collected from 74 Korean hospitals. Povidone iodine after either isopropyl alcohol or ethanol application was the most common way of skin disinfection. Sampling of a second set of cultures was performed simultaneously in 38% of hospitals and after a 30-min interval in 50%. The recommended blood volume was predominantly 10 mL (69%), whereas 20 mL only in 24%. The bottles were stored at 37oC in 23% and at room temperature in 16% before installation, whereas 57% placed directly in the equipment during the night shift. Positive rates ranged 8-10% at 32% of hospitals, 5-8% at 23%, and ＜5% at 12%. Skin contamination rates were 2-3% at 32%, 1-2% at 27%, and ＞3% at 13% of hospitals, respectively. Conclusion: Skin disinfection method was rather variable. Sampling interval, blood volume, and storage of bottles should be standardized. More than 10% of the hospitals are required for quality improvement in terms of positive rate and skin contamination rates
Abstract
Background: Although many laboratories use automated blood culture systems, adequate skin disinfection and optimal blood volume are still critical for successful culture. The authors undertook a nationwide survey to understand the current situation and problems of blood culture in Korea. Methods: A survey of blood culture was performed in March and April 2010, including disinfectants, blood collection intervals, and recommended blood volumes. The laboratory physicians described the storage condition of culture bottles before delivery to the equipment. For quality control, the positive rate and skin contamination rate were enlisted. Results: Replies to the survey were collected from 74 Korean hospitals. Povidone iodine after either isopropyl alcohol or ethanol application was the most common way of skin disinfection. Sampling of a second set of cultures was performed simultaneously in 38% of hospitals and after a 30-min interval in 50%. The recommended blood volume was predominantly 10 mL (69%), whereas 20 mL only in 24%. The bottles were stored at 37oC in 23% and at room temperature in 16% before installation, whereas 57% placed directly in the equipment during the night shift. Positive rates ranged 8-10% at 32% of hospitals, 5-8% at 23%, and ＜5% at 12%. Skin contamination rates were 2-3% at 32%, 1-2% at 27%, and ＞3% at 13% of hospitals, respectively. Conclusion: Skin disinfection method was rather variable. Sampling interval, blood volume, and storage of bottles should be standardized. More than 10% of the hospitals are required for quality improvement in terms of positive rate and skin contamination rates
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