Single-venipuncture strategy for blood culture collection
Abstract:
Introduction: Blood volume is the main determinant of blood culture diagnostic yield. Although guidelines recommend obtaining at least two complete sets, the traditional multiple extraction (ME) strategy requires two venipunctures, whereas the single extraction (SE) strategy uses one venipuncture to inoculate all four bottles. The aim of this study was to evaluate the impact of SE on the diagnostic performance of blood cultures in a high-demand emergency department.
Methods: A quasi-experimental observational study with a beforeafter design was conducted. The SE protocol was implemented in March 2023. Three periods were analysed: pre-intervention (2022, ME), post-intervention (April 2023-March 2024, SE), and follow-up (June 2024-May 2025, SE). Blood cultures were processed using BD BACTEC™ FX, and data were retrieved from BD EpiCenter™ and the laboratory information system.
Results: A total of 4614 blood cultures from 3206 patients were analysed in the pre-intervention period and 4974 cultures from 3756 patients in the postintervention period. After SE implementation, solitary cultures decreased significantly (85.9% to 7.2%) and contamination rates dropped (6.5% to 3.5%) (p < 0.05). True bacteremias increased slightly (16.2%-17.4%) without statistical significance. Improvements were sustained in the followup period, with contamination rates reaching 2.5% and falling for the first time below the 3% quality threshold.
Conclusions: The SE strategy improves blood culture quality by significantly reducing solitary and contaminated samples without compromising the detection of true bacteremias. Its implementation may optimise diagnostic performance and promote more rational use of resources in high-pressure emergency settings.
Reference:
Gimeno Gascón A, Molina Gil-Bermejo J, Trigo Sorroche F, Navarro Navarro MC, Aguilar Guisado M, Peñalva Moreno G, Guisado Gil AB, Bueno Mariscal C, Cisneros Herreros JM, Lepe Jimenez JA. Evaluating a single-venipuncture strategy for blood culture collection. Enferm Infecc Microbiol Clin (Engl Ed). 2026 Mar 10;44(4):503105. doi: 10.1016/j.eimce.2026.503105. Epub ahead of print. PMID: 41812290.