Clinical Characteristics Associated with Blood Culture Contamination in Neonates

Min Young Jung; 0k Sung Son; You Rha Hong; Chi Eun Oh

doi:10.14776/piv.2015.22.3.147

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Young Jung, Son, Hong, and Oh: Clinical Characteristics Associated with Blood Culture Contamination in Neonates

Original Article

Pediatr Infect Vaccine 2015;22(3):147-153.

Published online: 21 January 2015

DOI: https://doi.org/10.14776/piv.2015.22.3.147

Clinical Characteristics Associated with Blood Culture Contamination in Neonates

Min Young Jung, 0k Sung Son, You Rha Hong, Chi Eun Oh

Department of Pediatrics, Kosin University College of Medicine, Busan, Korea

Received 4 May 201513 June 2015 Accepted 15 June 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was aimed to investigate the contamination rates of blood culture in a neonatal intensive care unit (NICU) and to exa—mine the clinical characteristics related to the contamination. Methods: Eight hundred thirty cases of blood culture performed from March 2013 to February 2014 were analyzed. We evaluated the contamination rates of blood culture by blood sampling sites and compared the clinical characteristics such as real name system and body weights of the contaminated cases and those of non—contaminated ones. The clinical characteristics were retrospectively reviewed by medical records. Results: The overall contamination rate was 3.6% (30/830). The contamination rates by blood sampling sites were as follows: peripheral vein 15.6% (10/64), peripheral artery 2.6% (20/759), and umbilical arterial catheter 0% (0/7). There was no difference in the contamination rates between cases with and without real name system (P=O.484). However, there were significant differences in the contamination rates by the physicians who performed the culture (P=0.038) and body weight (<1,000 9 vs. 21,000 g) at the time of blood culture (P<0.001). Conclusions: These results suggest that neonates with a body weight less than 1,000 9 have more risks of the contamination of blood cul—ture. Furthermore, there is a necessity to provide blood culture performers with active feedbacks and individualized education plans that can help diminish blood culture contamination rates. Prospective studies in a systematic manner that can be applied in actual clinical settings are needed in order to figure out factors that can diminish the contamination rates of blood culture in NICU.

Keywords: Blood, Culture, Contamination, Neonates

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Fig. 1.

Contamination rates in peripheral blood culture by physicians during the period of the real name system.

Table 1.

Bacteria Considered True Pathogens and Contaminants in Blood Specimens Obtained in a Single Neonatal lntensive Care Unit from March 2013 to February 2014

	No (%) of identified bacteria
	True pathgens (n=16)	Contaminants (n=30)
Coagulase-neuative staohvlococci	4(25)	28(93.3)
Staphylococcus aureus	8 (50)	0
Escheichis coil	2(12.5)	0
StrepIococcus lutetensis	2(12.5)	0
Enterococcus faecails	0	1 (3.3)
Ioagulase-negative staphylococci and Enterococos faecails	0	1 (3.3)

Table 2.

Rates of Contamination and Bacteremia by Blood Sampling Sites

	Peripheral vessles		Umbilical artery catheter (n=7)	Total (n=830)
	Artery (n=759)	Vein (n=64)	Umbilical artery catheter (n=7)	Total (n=830)
Contamination	20 (2.6)	10 (15.6)	0 (0.0)	30 (3.6)
Bacteremia	12 (1.6)	3 (4.7)	1 (14.3)	16(19)
Jo growth	727 (95.8)	51 (/91)	6 (8.7)	784 (94.5)

Data are presented as n (%).

Table 3.

Comparison of Clinical Factors between Contamination and No Contamination Group in Peripheral Blood Cultures

	No contamination (N=793)	Contamination (N=30)	p value
Body weight∗, median (min-max)	1,997 (525-6,5)	1,630 (512-5,280)	0.087^†
Body weight∗ <1,000 g, n (%)	80 (10.0)	11 (36.7)	0.000
Real name system^‡, n (%)	548 (79.1)	25 (86.2)	0.484

^∗ It was measured on the day of blood specimen collection.

^† Mann-Whitney U test.

^‡ The name of the physician who took the blood culture sample was recorded on the laboratory results record sheet; No contamination group (N=693), contamination roup (N=29).

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