➡️ Does your 🏥 use the Blood culture strategy of;
ONE venipuncture
(4 bottles x 1 puncture)
or
TWO venipunctures
(2 bottles x 2 punctures)
➡️ If ONE, do you like it?
#IDsky #Medsky
ONE venipuncture
(4 bottles x 1 puncture)
or
TWO venipunctures
(2 bottles x 2 punctures)
➡️ If ONE, do you like it?
#IDsky #Medsky
Comments
Data about diversion devices show a 50-66% reduction in contamination. Based on this, the majority of contamination *should* be limited to the first bottle.
For the remainder of contamination, I absolutely agree that it will cloud interpretation.
The typical fill on the bottles is 8 mL, so by the time we get to the third (aerobic) bottle, there shouldn't be any contamination left.
Do you ask for 2x2 blood cultures when you suspect a vascular infection? Why or why not?
Very convincing data out of Sweden and France. I recall someone from Quebec said at ESCMID that this would become the provincial guidance (or did I hallucinate it?!)
https://pubmed.ncbi.nlm.nih.gov/34851687/
https://pubmed.ncbi.nlm.nih.gov/37317789/
#IDSky
https://pubmed.ncbi.nlm.nih.gov/36867272/
#IDSky
It doesn’t look like you would get to 20-40 ml w/ single stick (average ~8 ml from 6-7 ml)
I am still struggling to see the benefit outside of pt satisfaction and cost
A group of « experts » decided that single venipuncture was the way to go and published « provincial recommendation » in July without consultation with central labs etc
I would say that 95% don’t agree 😉
What matters are volumes.
Also, less discomfort for patient and faster for nursing
There is probably a good case for it, but it changes noticeably our interpretation of blood cultures and thus needs to be explained and the way the test is interpreted, adapted.
@sebpoule.bsky.social
Hope ya’ll get to a good place ☺️
It’s already a mess w/ 2x2.
The # of calls we get about obvious contaminants or questions about 2x2 is crazy
I fear my life will end w/ 4x1
But I can open my mind
@dr-jd.bsky.social
https://pubmed.ncbi.nlm.nih.gov/21499970/
#IDSky
We all know that ED take blood cultures, give ATB and think later. They will not say oh, « it’s probably an endovascular infection » let’s use 2x2
@dr-jd.bsky.social
https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2016.00697/full
Had suggested to prepare a review so that part of the work not be lost.
Also, I hate drawing cx’s from line. I don’t care about time to positivity. If you have 3 days of positive blood cxs, I am pulling the line.
#IDsky
When it comes to NHSN, this would actually be a loophole (the “single vs two draw and how far apart), and may not even matter with the move to reporting HO-BSI
I’m not convinced, yet