Improving Blood Culture Management in an Era of Hospital Onset Bacteremia

Session Description: Hospital-based infection prevention (IP) programs will need to institute new strategies to address proposed revisions by the Centers for Medicare and Medicaid Services that requires identification and prevention of all-cause Hospital Onset Bacteremia (HOB), including associations with all vascular access devices. In addressing such modifications, organizations will require system-wide coordination of comprehensive core components to effectively expand a more universal approach to IP. Moreover, recent nationwide blood culture (BC) shortages have prompted the Centers for Disease Control and Prevention, the American Society of Microbiology, the Association of Professionals in Infection Control and Epidemiology, and the Food and Drug Administration, to issue advisories and provide recommendations for optimizing practice.

Of initial importance to HOB mitigation, strategies should address a review of BC collection practices due to the frequent association with contamination, and subsequent false-positive results. Three principal BC interventions for consideration: implementing evidence-based decision aids in the ordering of BCs, standardizing methods for proper collection, and consideration of guideline recommended diversion of the first portion of blood which removes the contaminating organism from the remaining aliquot of blood. The evolution of blood stream infection prevention in hospitals to a universal all-cause approach will require a broader promotion of core component strategies across all disciplines.