Abstract

BACKGROUNDBlood culture is a standard clinical procedure used to identify the source of infection and establish the appropriate treatment plan.1 It is essential for detecting bacteremia, which is a critical health problem. For accurate identification of bacteremia, several guidelines recommend collecting two or more sets of samples for blood culture.2,3 However, blood culture contamination occurs in 0.6%–12.5% of samples,4 which leads to unnecessary intervention, inappropriate antibiotic use, and excess cost. The American Society of Microbiology recommends keeping the contamination rate under 3%.2 For comparison, contamination occurs in 0.6%–1.0% of samples in our hospital.Previous studies showed that blood culture procedures, such as skin sterilization or puncture site selection, are associated with contamination.5–7 As for puncture site, it is well known that the femoral artery is vulnerable to contaminate. In Japan, the puncturing artery is only allowed to physicians and specific nurse practitioners. Other registered nurses are allowed to collect a blood sample from vein. Usually, chlorhexidine is used for sterilizing skin, and physicians or nurses wear sterile gloves. Specimen collection site, inadequate skin preparation, and lack of sterile gloving contribute to contamination.8 However, studies on patient factors are limited. Sinclair et al.9 showed a high rate of false‐positive blood cultures