Abstract:
Abstract:
Background: Blood cultures (BC) are essential for the diagnosis of bloodstream infections (BSI). BSI can be inaccurately attributed due to BC contamination or bacterial translocation. Reporting BCs after patient death can be inaccurate and potentially increase BSI incidence.
Methods: The study was performed in two phases. A three-year retrospective review where all positive BCs that resulted after patient death (PD) were reviewed for hospital associated infections (HAI). In the 18-month prospective phase, a concurrent review of pending BCs after PD was implemented to discontinue BC processing. A cost-benefit analysis was conducted of the program considering the cost of HAIs.
Results: During the retrospective phase there were 4,868 positive BC (10%) of which 407 (8%) were finalized after PD. The BCs that resulted after PD and were identified as HAI included 8 CLABSI (Central Line Associated Blood Stream Infections), 11 primary and 25 secondary BSIs. During the prospective phase, the infection preventionists reviewed 795 patients and identified 285 with pending BC at the time of PD. 90.5% of these cultures were cancelled, reducing the number of CLABSI reported per year by 31.9%.
Conclusion: HAI rates could be falsely increased as NHSN (National Healthcare Safety Network) definitions do not address positive BC after PD. Implementing a stewardship protocol to discontinue BCs after PD is appropriate clinical practice and likely cost beneficial.
Reference:
Heather D, Mathea S, Cardiff A, Smith K, Mohamed Y. Blood cultures processing after death: best practice, cost-effective, or HAI reduction measure. Am J Infect Control. 2025 Aug 22:S0196-6553(25)00526-7. doi: 10.1016/j.ajic.2025.08.014. Epub ahead of print. PMID: 40850472.