Abstract
Background: Contamination of blood cultures creates problems in their interpretation
and unneeded resource utilization. Because skin flora comprise the major group of
contaminant species, more effective skin disinfection at the venipuncture site could
reduce contamination.
Subjects and methods: We performed a randomized trial in adult inpatients at a tertiary
care teaching hospital. Antecubital venipuncture sites were randomly disinfected with
povidone-iodine or iodine tincture, and blood cultures (two bottles, 10 mL of blood)
were drawn by professional phlebotomists. Scoring of contaminant species was restricted
to skin flora. Hospital resource utilization was compared among patients with contaminated
blood cultures and those with sterile blood cultures.
Results: Of the 3,851 blood cultures collected during the study, 120 (3.1%) were contaminated
with skin flora. The contamination rate for blood cultures collected after povidone-iodine
was 3.8% (74 of 1,947), compared with a rate of 2.4% (46 of 1,904, P = 0.01) after iodine tincture. The difference in mean total hospital costs for patients
with contaminated blood cultures and those with sterile blood cultures was $4,100
(95% confidence interval: $740 to $7,400, P = 0.02).
Conclusions: Iodine tincture is superior to povidone-iodine for venipuncture site
antisepsis before blood culture sampling. Because of the high costs associated with
contaminated blood cultures, hospitals should consider switching from povidone-iodine
to iodine tincture. Reduction of the contamination rate may improve the quality of
patient care and reduce hospital costs.
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Article Info
Publication History
Published online: August 16, 2004
Accepted:
April 14,
1999
Received in revised form:
April 14,
1999
Received:
September 28,
1998
Footnotes
☆Funding for this investigation was provided by the Innovations in Healthcare Program of the BJC Health System, St. Louis, Missouri. The kits containing 2% iodine tincture and an alcohol scrub device (Blood Culture Prep Kit II) were supplied by Medi-Flex Hospital Products, Inc, Overland Park, Kansas.
Identification
Copyright
© 1999 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
