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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
Promoting an Active Collection of 2 Sets of Blood Cultures Increased Positive Culture Rate in a Regional Core Hospital |
| Language |
J |
| AuthorList |
Yasufumi Matsumura1,2), Tsunehiro Shimizu1), Akihiko Hayashi3) |
| Affiliation |
1) Department of Infectious Diseases, Kyoto City Hospital
2) Current affiliation: Department of Clinical Laboratory Medicine, Graduate School of Medicine, Kyoto University
3) Department of Laboratory Medicine, Kyoto City Hospital |
| Publication |
J.J.C.M.: 20 (3), 169-176, 2010 |
| Received |
December 20, 2009 |
| Accepted |
July 12, 2010 |
| Abstract |
The number of blood cultures to be taken is generally insufficient for clinical practices of infectious diseases in Japan, which makes it difficult to detect the infectious agents and to choose an appropriate antimicrobial therapy. It is also hard to discriminate truly positive culture from contamination, because most clinicians collect blood cultures with only 1 set. In 586-beds regional core hospital, we have promoted collecting 2 sets of blood cultures through resident education and consultation on the patients with positive blood culture for 3 years since 2006. The number of blood cultures increased from 2002 to 3,012, 3,537, 3,984 sets from 2005 to 2008. Two or more sets rate in adults showed significant increases from 12% to 56%, 87%, 92%. The overall contamination rate was stable as low as 0.9% although contamination rate of adult outpatient was higher (1.5%). The positive rate per set was the highest in adult outpatients (18.0%), followed by adult inpatient (12.5%) and children (8.1%). The overall positive rate per set was 13.1% without significant changes. The positive rate per patient with 1 set was 10.2%, and that with 2 or more sets was 16.4%. The positive rate ratio for 2 or more sets to 1 set was 1.60 (95% confidence interval: 1.41-1.80). We have succeeded in promotion of collecting 2 sets of blood cultures, because we have been making an emphasis on the importance of taking 2 sets to diagnose infectious diseases and educating especially young residents. Increasing 2 sets of blood cultures will become one of important steps to improve a quality of infection control in Japan. |
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