Proposing an empirically justified reference threshold for blood culture sampling rates in intensive care units.

2.50
Hdl Handle:
http://hdl.handle.net/10033/600847
Title:
Proposing an empirically justified reference threshold for blood culture sampling rates in intensive care units.
Authors:
Karch, André ( 0000-0003-3014-8543 ) ; Castell, Stefanie; Schwab, Frank; Geffers, Christine; Bongartz, Hannah; Brunkhorst, Frank M; Gastmeier, Petra; Mikolajczyk, Rafael T ( 0000-0003-1271-7204 )
Abstract:
Early and appropriate blood culture sampling is recommended as a standard of care for patients with suspected bloodstream infections (BSI) but is rarely taken into account when quality indicators for BSI are evaluated. To date, sampling of about 100 to 200 blood culture sets per 1,000 patient-days is recommended as the target range for blood culture rates. However, the empirical basis of this recommendation is not clear. The aim of the current study was to analyze the association between blood culture rates and observed BSI rates and to derive a reference threshold for blood culture rates in intensive care units (ICUs). This study is based on data from 223 ICUs taking part in the German hospital infection surveillance system. We applied locally weighted regression and segmented Poisson regression to assess the association between blood culture rates and BSI rates. Below 80 to 90 blood culture sets per 1,000 patient-days, observed BSI rates increased with increasing blood culture rates, while there was no further increase above this threshold. Segmented Poisson regression located the threshold at 87 (95% confidence interval, 54 to 120) blood culture sets per 1,000 patient-days. Only one-third of the investigated ICUs displayed blood culture rates above this threshold. We provided empirical justification for a blood culture target threshold in ICUs. In the majority of the studied ICUs, blood culture sampling rates were below this threshold. This suggests that a substantial fraction of BSI cases might remain undetected; reporting observed BSI rates as a quality indicator without sufficiently high blood culture rates might be misleading.
Affiliation:
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Citation:
Proposing an empirically justified reference threshold for blood culture sampling rates in intensive care units. 2015, 53 (2):648-52 J. Clin. Microbiol.
Journal:
Journal of clinical microbiology
Issue Date:
Feb-2015
URI:
http://hdl.handle.net/10033/600847
DOI:
10.1128/JCM.02944-14
PubMed ID:
25520442
Type:
Article
Language:
en
ISSN:
1098-660X
Appears in Collections:
Publications of the AG (ESME)

Full metadata record

DC FieldValue Language
dc.contributor.authorKarch, Andréen
dc.contributor.authorCastell, Stefanieen
dc.contributor.authorSchwab, Franken
dc.contributor.authorGeffers, Christineen
dc.contributor.authorBongartz, Hannahen
dc.contributor.authorBrunkhorst, Frank Men
dc.contributor.authorGastmeier, Petraen
dc.contributor.authorMikolajczyk, Rafael Ten
dc.date.accessioned2016-03-08T10:07:42Zen
dc.date.available2016-03-08T10:07:42Zen
dc.date.issued2015-02en
dc.identifier.citationProposing an empirically justified reference threshold for blood culture sampling rates in intensive care units. 2015, 53 (2):648-52 J. Clin. Microbiol.en
dc.identifier.issn1098-660Xen
dc.identifier.pmid25520442en
dc.identifier.doi10.1128/JCM.02944-14en
dc.identifier.urihttp://hdl.handle.net/10033/600847en
dc.description.abstractEarly and appropriate blood culture sampling is recommended as a standard of care for patients with suspected bloodstream infections (BSI) but is rarely taken into account when quality indicators for BSI are evaluated. To date, sampling of about 100 to 200 blood culture sets per 1,000 patient-days is recommended as the target range for blood culture rates. However, the empirical basis of this recommendation is not clear. The aim of the current study was to analyze the association between blood culture rates and observed BSI rates and to derive a reference threshold for blood culture rates in intensive care units (ICUs). This study is based on data from 223 ICUs taking part in the German hospital infection surveillance system. We applied locally weighted regression and segmented Poisson regression to assess the association between blood culture rates and BSI rates. Below 80 to 90 blood culture sets per 1,000 patient-days, observed BSI rates increased with increasing blood culture rates, while there was no further increase above this threshold. Segmented Poisson regression located the threshold at 87 (95% confidence interval, 54 to 120) blood culture sets per 1,000 patient-days. Only one-third of the investigated ICUs displayed blood culture rates above this threshold. We provided empirical justification for a blood culture target threshold in ICUs. In the majority of the studied ICUs, blood culture sampling rates were below this threshold. This suggests that a substantial fraction of BSI cases might remain undetected; reporting observed BSI rates as a quality indicator without sufficiently high blood culture rates might be misleading.en
dc.language.isoenen
dc.subject.meshBlooden
dc.subject.meshCritical Careen
dc.subject.meshEpidemiological Monitoringen
dc.subject.meshHumansen
dc.subject.meshIntensive Care Unitsen
dc.subject.meshMicrobiological Techniquesen
dc.subject.meshSepsisen
dc.subject.meshSpecimen Handlingen
dc.titleProposing an empirically justified reference threshold for blood culture sampling rates in intensive care units.en
dc.typeArticleen
dc.contributor.departmentHelmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.en
dc.identifier.journalJournal of clinical microbiologyen

Related articles on PubMed

This item is licensed under a Creative Commons License
Creative Commons
All Items in HZI are protected by copyright, with all rights reserved, unless otherwise indicated.