Evaluation of an Internal Hospital Practice: The Effect of Altered Test Tubes Sampling Order on Blood Culture Contamination Rates

NCT03088865 | Completed

• 1 other identifier: 0017-17-HMO
• Study Type: interventional
• Target: 756
• Locations: 1 country
• Sites: 1

Brief Summary

Implementation of the initial specimen diversion technique, in which the first milliliter of the venipuncture sample is not injected into the culture bottle, led to a significant reduction in blood culture contamination rates. This technique is based on the assumption that the skin plug aspirated during venipuncture is a major source of contaminating bacteria. One such diversion method is aspirating the first blood volume into a blood collection tube. It has, however, been suggested that regular blood collection tubes carry contaminants from the tube's stopper into the blood cultures drawn afterwards, thereby increasing contamination rates. The aim of this trial is to examine the effect of aspirating the first blood volume into a regular blood collection tube on blood culture contamination rate.

Conditions

Septicemia

Outcome Measures

Primary Outcomes (1)

• Blood culture contamination rate

  A blood culture contamination is defined as growth in a single set of coagulase-negative Staphylococcus, Micrococcus, Viridans group Streptococcus, Propionibacterium acne, Corynebacterium sp (diphtheroids) or Bacillus sp.

  7 days

Study Arms (2)

Initial Specimen Diversion

EXPERIMENTAL

Aspirating first blood volume into a regular blood collection tube

Diagnostic Test: aspirating first blood volume into a regular blood collection tube

Standard practice

ACTIVE COMPARATOR

Aspirating first blood into blood culture bottles (Standard practice)

Diagnostic Test: aspirating first blood volume into a regular blood collection tube

Interventions

aspirating first blood volume into a regular blood collection tube DIAGNOSTIC_TEST

order of blood drawing

Initial Specimen Diversion; Standard practice

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults evaluated in the emergency room or as inpatients for suspected sepsis or having sepsis and from whom the treating physician plans to take, in the same venous puncture, blood cultures and additional blood tests (blood count and/or blood chemistry).

You may not qualify if:

• None

Sponsors & Collaborators

• Hadassah Medical Organization: lead

Study Sites (1)

Hadassah Medical Center

Jerusalem, 91120, Israel

Location

Related Publications (1)

• Lalezari A, Cohen MJ, Svinik O, Tel-Zur O, Sinvani S, Al-Dayem YA, Block C, Moses AE, Oster Y, Salameh S, Strahilevitz J. A simplified blood culture sampling protocol for reducing contamination and costs: a randomized controlled trial. Clin Microbiol Infect. 2020 Apr;26(4):470-474. doi: 10.1016/j.cmi.2019.09.005. Epub 2019 Sep 17.

  PMID: 31539635 DERIVED

MeSH Terms

Conditions

Sepsis

Condition Hierarchy (Ancestors)

Infections; Systemic Inflammatory Response Syndrome; Inflammation; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 9, 2017
• First Posted: March 23, 2017
• Study Start: September 1, 2017
• Primary Completion: September 6, 2018
• Study Completion: September 6, 2018
• Last Updated: July 29, 2020

Record last verified: 2020-02

Locations

IL (1)