A Quality Control Circle Process to Reduce Blood Culture Contamination Rates

Yu-Zhong Yan; Huan-Zhang Yang; Jiang-Xia Zhao; Rong Xia

doi:10.1017/ice.2018.271

Baseline Study for Improving Diagnostic Stewardship at Secondary Health Care Facilities in Nigeria

10.21203/rs.3.rs-829161/v1 ◽

2021 ◽

Author(s):

Abiodun Egwuenu ◽

Adaora Ejikeme ◽

Sara Tomczyk ◽

Anja Von-Laer ◽

Olaniyi Ayobami ◽

...

Keyword(s):

Health Care ◽

Quality Control ◽

Blood Culture ◽

Online Survey ◽

Case Finding ◽

Blood Cultures ◽

Health Care Facilities ◽

Suspected Sepsis ◽

Care Facilities ◽

Secondary Health Care

Abstract BackgroundBlood culture diagnostics are a critical tool for sepsis management and antimicrobial resistance (AMR) surveillance. A baseline study was conducted to assess existing sepsis case finding, blood culture diagnostics and antimicrobial susceptibility testing (AST) at secondary health care facilities to inform the development of diagnostic stewardship improvement strategies in Nigeria.MethodsA cross-sectional online survey was conducted among 25 public secondary health care facilities in Abuja, FCT and Lagos State in Nigeria to evaluate the capacity for pathogen identification and AST. Following this, data were prospectively extracted on all patients with suspected sepsis from electronic medical records at two facilities in Abuja from October 2020 to May 2021 to further assess practices concerning sepsis case-finding, clinical examination findings, samples requested, and laboratory test results. Data were descriptively analysed, and a multivariate logistic regression analysis was conducted to determine factors associated with blood culture requests among suspected sepsis patients.ResultsIn the online survey, 32% (8/25) of facilities reported performing routine blood cultures. Only one had access to a clinical microbiologist, and 28% (7/25) and 4% (1/25) used standard bacterial organisms for quality control of media and quality control strains for AST, respectively. At the two facilities where data abstraction was performed, 7.1% (2924/41066) of patients were found to have suspected sepsis. A majority of the suspected sepsis patients came from the paediatrics department and were outpatients, and the median age was two years. Most did not have vital signs and major foci of infection documented. Blood cultures were only requested for 2.7% (80/2924) of patients, of which twelve were positive for bacteria, mainly Staphylococcus aureus. No clinical breakpoints were used for AST. Inpatients (adjusted odds ratio [aOR]:7.5, 95% CI:4.6 – 12.3) and patients from the urban health care facility (aOR:16.9, 95% CI:8.1 – 41.4) were significantly more likely to have a blood culture requested.ConclusionLow blood culture utilisation remains a key challenge in Nigeria. This has implications for patient care. AMR surveillance and antibiotics use. Diagnostic stewardship strategies should focus on improving access to clinical microbiology expertise, practical guidance on sepsis case finding and improving blood culture utilisation and diagnostics.

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Performance Evaluation of the VersaTREK Blood Culture System for Quality Control Testing of Platelet Units

Journal of Clinical Microbiology ◽

10.1128/jcm.02173-08 ◽

2009 ◽

Vol 47 (3) ◽

pp. 817-818 ◽

Cited By ~ 7

Author(s):

S. Nanua ◽

C. Weber ◽

L. Isgriggs ◽

W. M. Dunne

Keyword(s):

Quality Control ◽

Performance Evaluation ◽

Blood Culture ◽

Culture System ◽

Blood Culture System ◽

Quality Control Testing

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A quality control circle process to improve implementation effect of prevention measures for high-risk patients

International Wound Journal ◽

10.1111/iwj.12764 ◽

2017 ◽

Vol 14 (6) ◽

pp. 1094-1099 ◽

Cited By ~ 4

Author(s):

Haixia Feng ◽

Guohong Li ◽

Cuirong Xu ◽

Changping Ju ◽

Peiheng Suo

Keyword(s):

Quality Control ◽

High Risk ◽

Prevention Measures ◽

High Risk Patients ◽

Circle Process ◽

Risk Patients ◽

Implementation Effect

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Evaluation of Twenty-Three Blood Culture Media

Journal of Clinical Microbiology ◽

10.1128/jcm.8.3.288-292.1978 ◽

1978 ◽

Vol 8 (3) ◽

pp. 288-292

Author(s):

Jegdish P. Babu ◽

Ronald F. Schell ◽

Jack L. Le Frock

Keyword(s):

Quality Control ◽

Blood Culture ◽

Recovery Rate ◽

Culture Medium ◽

Culture Media ◽

Control Measures ◽

Rate Of Recovery ◽

The Difference

Several investigators have evaluated clinically a variety of commercially available blood culture media. No agreement has been reached as to which of these media is optimal for detection of bacteremia. The purpose of this study was to determine the rate of recovery of microorganisms from various blood culture media. A total of 23 blood culture media were inoculated with 7 to 15 microorganisms per bottle in the presence or absence of an erythrocyte-serum mixture. The results demonstrated that blood culture media differed in their ability to support the growth of microorganisms. At 4 days after inoculation, only 10 of the 23 blood culture media supported the growth of 91% (10 of the 11) or more of the test microorganisms. The recovery rate of microorganisms depended not only upon the type of medium but also upon the manufacturer of the type of blood culture medium. The addition of an erythrocyte-serum mixture to the blood culture media did not influence the difference in the recovery rate of microorganisms among media and the same type of medium prepared by different manufacturers. The majority (15 of the 23) of the blood culture media supplemented with the erythrocyte-serum mixture failed to support the growth of 91% or more of the test microorganisms at 4 days after inoculation. These results have demonstrated that blood culture media need to be improved. Better quality control measures should also be implemented to evaluate commercial blood culture media.

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