Low Blood Culture Contamination Rates Sustained in Children during the COVID-19 Pandemic
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Background The coronavirus disease 2019 (COVID-19) pandemic has led to many changes in medical practice. For example, some adult studies have reported that the strict implementation of universal precautions increased blood culture contamination rates. However, little evidence exists in children, and its relevance to pediatrics remains unclear. Materials and Methods This retrospective observational study was conducted at a tertiary children’s hospital in Japan where the emergency department (ED) physicians receive active monthly feedback for changes in blood culture contamination rates. The data were extracted from medical records of children under 18 years old. The number of patients who visited the ED, number of blood culture bottles drawn, results of positive blood cultures, and sources of infection were compared between the pre-COVID-19 (1/2017–12/2019) and COVID-19 (1/2020–12/2022) periods. Results During each period, 83,224 and 57,742 patients visited the ED, and 12,571 and 9,409 blood cultures were obtained, respectively. The contamination rates were unchanged, with average rates of 1.0% in both periods (P=0.54). Occult bacteremia decreased (from 36 to 9 cases; P=0.015), and the proportion of bacteremia attributable to respiratory pathogens also declined (P=0.015). Conclusion Active feedback is likely to maintain low contamination rates during the pandemic. The decrease in occult bacteremia suggests that enhanced infection control measures influenced pediatric infectious disease patterns.
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has led to many changes in medical practice. For example, some adult studies have reported that the strict implementation of universal precautions increased blood culture contamination rates. However, little evidence exists in children, and its relevance to pediatrics remains unclear. Materials and Methods This retrospective observational study was conducted at a tertiary children’s hospital in Japan where the emergency department (ED) physicians receive active monthly feedback for changes in blood culture contamination rates. The data were extracted from medical records of children under 18 years old. The number of patients who visited the ED, number of blood culture bottles drawn, results of positive blood cultures, and sources of infection were compared between the pre-COVID-19 (1/2017–12/2019) and COVID-19 (1/2020–12/2022) periods. Results During each period, 83,224 and 57,742 patients visited the ED, and 12,571 and 9,409 blood cultures were obtained, respectively. The contamination rates were unchanged, with average rates of 1.0% in both periods (P=0.54). Occult bacteremia decreased (from 36 to 9 cases; P=0.015), and the proportion of bacteremia attributable to respiratory pathogens also declined (P=0.015). Conclusion Active feedback is likely to maintain low contamination rates during the pandemic. The decrease in occult bacteremia suggests that enhanced infection control measures influenced pediatric infectious disease patterns.