660. Effect of the COVID-19 Pandemic on Blood Culture Contamination Rates and Quality Improvement Processes
660. Effect of the COVID-19 Pandemic on Blood Culture Contamination Rates and Quality Improvement...
Hosse, Alexander G
2021-12-04 00:00:00
in the use of diversion devices) used diversion devices to draw 51 of 133 (38.3%) cul- tures compared to only 15 of 84 (17.9%) on the COVID inpatient units. Figure 1. Comparison of contamination rates in the ED vs the inpatient units from all campuses from September 2019 through September 2020. The blue line represents the hospital goal of 2.25% contamination rate. Solid lines represent total contamination rates including COVID isolation units whereas dotted lines represent units excluding COVID isolation units. Conclusion. Interpretative comments in reports act as a bridge between clinical Figure 2. Comparison of the non-COVID vs COVID isolation units in the emergency microbiology, infectious diseases and infection control. They help us to choose the department and inpatient units. The red line represents the hospital goal of less than correct antibiotics or sometimes no antibiotics when the situation demands it. With 2.25% for blood culture contamination rate. all the recent advancements, the clinico-microbiological utility of culture reports is the need of the hour. Table of Contaminants vs. Total Collected Blood Cultures in Each Unit by Month Figure 3. Raw data from Figure 2. Total blood culture contaminations from each unit by month compared to total blood culture collections from each unit by month. Conclusion. Evaluation revealed that nursing staff with less training in blood cul - Disclosures. All Authors: No reported disclosures ture collection, particularly the use of diversion devices, were the primary staff collect - ing blood cultures in the inpatient COVID units. The difference in training is felt to be the primary driver of the increase in contaminants in the inpatient COVID units. The marked increase in contaminations highlights the difficulties of maintaining quality 660. Effect of the COVID-19 Pandemic on Blood Culture Contamination Rates control processes during an evolving pandemic and the importance of ongoing efforts and Quality Improvement Processes 1 1 to improve the quality of care. These findings demonstrate the importance of training Alexander G. Hosse, MD ; Louisiana State University School of Medicine, Baton and routine use of procedures to reduce contaminations even during. Rouge, Louisiana Disclosures. All Authors: No reported disclosures Session: P-29. Diagnostics: Bacteriology/mycobacteriology Background. Blood cultures are the gold standard for diagnosing bloodstream infections and a vital part of the work-up in systemic infections. However, contamin- 661. Clinical Utility and Impact of the Metagenomic Microbial Plasma Cell-Free ation of blood cultures represents a significant burden on patients and the healthcare DNA Next-Generation Sequencing Assay on Treatment Decision: a Single-Center system with increased hospital length of stay, unnecessary antibiotics, and financial Retrospective Study 1 1 1 cost. The data discussed here oer in ff sight into blood culture contamination rates be - Myint M. Noe, M.D ; Akira A. Shishido, M.D, FACP ; Kapil Saharia, M.D., M.P.H. ; 1 1 fore and through the COVID-19 pandemic at a community hospital and the processes Paul Luethy, PhD ; University of Maryland School of Medicine, Fort Myers, Florida that were ae ff cted by the pandemic. Session: P-30. Diagnostics: Typing/sequencing Methods. Blood culture contaminations were determined by using the number of sets of blood cultures with growth and the presence of an organism from the National Background. Metagenomic next-generation sequencing (mNGS) of microbial Healthcare Safety Network's (NHSN) commensal organism. Contamination rates were cell-free DNA (mcfDNA) allows for non-invasive broad-range pathogen detection evaluated by status as a standard unit or a COVID-19 isolation unit in either the emer- from plasma. The Karius® test that emerged in 2016 made mNGS widely available. gency department (ED) or inpatient floor units. The identified four groups had differ - However, there is little data describing the optimal role for this assay in clinical de- ent processes for drawing blood cultures, particularly in terms of training of staff in use cision making. of diversion devices. The electronic medical record was used to track contaminations Methods. We performed a single-center retrospective cohort study of adult patients and the use of diversion devices in the different units. for whom a Karius test was sent between May 2019 and February 2021 to assess clinical Results. e in Th patient COVID units were consistently elevated above the other utility. We predefined criteria for clinical impact categories (Table 1) and stratified data units and the institutional contaminant goal of 2.25%, ranging from 9.6% to 13.3% by patient comorbidities, infectious syndromes, duration of antimicrobial therapy prior from 4/2020-9/2020. os Th e units were the primary driver of the increase in overall to Karius testing, reasons for sending the test, and final clinical diagnoses. Clinical impact contamination rates. COVID ED nursing staff (that had previously undergone training was arbitrated by all authors aer r ft eview and discussion of each case. S432 • OFID 2021:8 (Suppl 1) • Abstracts
http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.pngOpen Forum Infectious DiseasesOxford University Presshttp://www.deepdyve.com/lp/oxford-university-press/660-effect-of-the-covid-19-pandemic-on-blood-culture-contamination-mH684Jj5pD
660. Effect of the COVID-19 Pandemic on Blood Culture Contamination Rates and Quality Improvement Processes
in the use of diversion devices) used diversion devices to draw 51 of 133 (38.3%) cul- tures compared to only 15 of 84 (17.9%) on the COVID inpatient units. Figure 1. Comparison of contamination rates in the ED vs the inpatient units from all campuses from September 2019 through September 2020. The blue line represents the hospital goal of 2.25% contamination rate. Solid lines represent total contamination rates including COVID isolation units whereas dotted lines represent units excluding COVID isolation units. Conclusion. Interpretative comments in reports act as a bridge between clinical Figure 2. Comparison of the non-COVID vs COVID isolation units in the emergency microbiology, infectious diseases and infection control. They help us to choose the department and inpatient units. The red line represents the hospital goal of less than correct antibiotics or sometimes no antibiotics when the situation demands it. With 2.25% for blood culture contamination rate. all the recent advancements, the clinico-microbiological utility of culture reports is the need of the hour. Table of Contaminants vs. Total Collected Blood Cultures in Each Unit by Month Figure 3. Raw data from Figure 2. Total blood culture contaminations from each unit by month compared to total blood culture collections from each unit by month. Conclusion. Evaluation revealed that nursing staff with less training in blood cul - Disclosures. All Authors: No reported disclosures ture collection, particularly the use of diversion devices, were the primary staff collect - ing blood cultures in the inpatient COVID units. The difference in training is felt to be the primary driver of the increase in contaminants in the inpatient COVID units. The marked increase in contaminations highlights the difficulties of maintaining quality 660. Effect of the COVID-19 Pandemic on Blood Culture Contamination Rates control processes during an evolving pandemic and the importance of ongoing efforts and Quality Improvement Processes 1 1 to improve the quality of care. These findings demonstrate the importance of training Alexander G. Hosse, MD ; Louisiana State University School of Medicine, Baton and routine use of procedures to reduce contaminations even during. Rouge, Louisiana Disclosures. All Authors: No reported disclosures Session: P-29. Diagnostics: Bacteriology/mycobacteriology Background. Blood cultures are the gold standard for diagnosing bloodstream infections and a vital part of the work-up in systemic infections. However, contamin- 661. Clinical Utility and Impact of the Metagenomic Microbial Plasma Cell-Free ation of blood cultures represents a significant burden on patients and the healthcare DNA Next-Generation Sequencing Assay on Treatment Decision: a Single-Center system with increased hospital length of stay, unnecessary antibiotics, and financial Retrospective Study 1 1 1 cost. The data discussed here oer in ff sight into blood culture contamination rates be - Myint M. Noe, M.D ; Akira A. Shishido, M.D, FACP ; Kapil Saharia, M.D., M.P.H. ; 1 1 fore and through the COVID-19 pandemic at a community hospital and the processes Paul Luethy, PhD ; University of Maryland School of Medicine, Fort Myers, Florida that were ae ff cted by the pandemic. Session: P-30. Diagnostics: Typing/sequencing Methods. Blood culture contaminations were determined by using the number of sets of blood cultures with growth and the presence of an organism from the National Background. Metagenomic next-generation sequencing (mNGS) of microbial Healthcare Safety Network's (NHSN) commensal organism. Contamination rates were cell-free DNA (mcfDNA) allows for non-invasive broad-range pathogen detection evaluated by status as a standard unit or a COVID-19 isolation unit in either the emer- from plasma. The Karius® test that emerged in 2016 made mNGS widely available. gency department (ED) or inpatient floor units. The identified four groups had differ - However, there is little data describing the optimal role for this assay in clinical de- ent processes for drawing blood cultures, particularly in terms of training of staff in use cision making. of diversion devices. The electronic medical record was used to track contaminations Methods. We performed a single-center retrospective cohort study of adult patients and the use of diversion devices in the different units. for whom a Karius test was sent between May 2019 and February 2021 to assess clinical Results. e in Th patient COVID units were consistently elevated above the other utility. We predefined criteria for clinical impact categories (Table 1) and stratified data units and the institutional contaminant goal of 2.25%, ranging from 9.6% to 13.3% by patient comorbidities, infectious syndromes, duration of antimicrobial therapy prior from 4/2020-9/2020. os Th e units were the primary driver of the increase in overall to Karius testing, reasons for sending the test, and final clinical diagnoses. Clinical impact contamination rates. COVID ED nursing staff (that had previously undergone training was arbitrated by all authors aer r ft eview and discussion of each case. S432 • OFID 2021:8 (Suppl 1) • Abstracts
Journal
Open Forum Infectious Diseases
– Oxford University Press
Published: Dec 4, 2021
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