Blood culture contamination in emergency department of a tertiary teaching hospital in North-Eastern Malaysia: Association with working shift, triage and stroke

Mohd Nizam, Zahary and Azizul Fadzli, Wan Jusoh@Ab Rahim and Nik Ahmad Shaiffudin, Nik Him and Rosliza, Yahaya (2017) Blood culture contamination in emergency department of a tertiary teaching hospital in North-Eastern Malaysia: Association with working shift, triage and stroke. Research Journal of Pharmacy and Technology, 10 (12). pp. 9-10. ISSN 0974-3618

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Abstract

Blood culture is a crucial investigation with major implication in the management of severe infection especially on the best-appropriate selection of anti-microbial therapy. Blood culture contamination can lead to adverse consequences such as inappropriate use of antibiotics, increased antibiotic resistance and prolonged hospital stay. The present study aimed to determine the prevalence of blood culture contamination and to investigate the factors associated with blood culture contamination such as patients, healthcare providers and environmental at Emergency Department, Hospital Universiti Sains Malaysia. A prospective cross-sectional study was conducted on sepsis, severe sepsis and septic shock patients from 1st September 2012 to 31st August 2013. One hundred and thirty six (136) consented patients who fulfilled criteria according to International Sepsis Guidelines and required intravenous antibiotics were enrolled into the study. Blood culture was processed according to the recommendations of the Clinical and Laboratory Standard Institute.Positive blood cultures were 44 (32.4%) with 27 of them were contaminated. The prevalence of blood culture contamination in the study population was 19.9%. Night shift work (OR, 4.73; CI, 1.35-16.57; p=0.015), semi-critical zone in triage (OR, 3.78; CI, 1.47- 9.73; p=0.006) and patients who have stroke (OR, 5.49; CI, 1.36-22.19; p=0.017) were found to be significantly associated with the risk for blood culture contamination. Cultures taken during night shift work, semi critical zone in triage and patients who have stroke are associated with the risk for blood culture contamination. These findings should be regarded as a time for change and provide an impetus towards improving patient care.

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