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OASCN Resources | Blood Culture Positivity, Timing and Contamination

These resources were developed by the OASCN Collaborative between 2021-2022.


Relevant Didactics:

  • Blood Culture Best Practice (Linda Lefrak): Slides | Video
  • Blood culture: Believing the information (Bill Benitz): Slides | Video
  • Is That Bug a Pathogen or Poseur? (Ken Zangwill): Slides | Video
  • Microbiology Laboratory: Primer for the NICU (Michael Bolaris): Slides | Video
  • Are you sure you know the strengths and weaknesses of blood culturing in your unit? A data-and OASCN data-driven presentation (Linda LeFrak): Slides | Video

Relevant Learning Points:

Learning Point #5: Blood cultures are very sensitive and have a high negative predictive value, if >1cc was sampled.

  • Understanding individual prescriber perceptions of blood culture sensitivity may identify important opportunities for improving stewardship.

Learning Point #6: Blood cultures should not be drawn from a UAC/UVC (risk of contamination) unless at insertion when still under sterile conditions.

Learning Point #7: S. epidermidis is a very rare cause of EOS; if two cultures are (+), make sure the antibiograms are the same. If antibiograms do not match, do not treat.

Learning Point #8: Timing, duration, and dose of maternal antibiotics is very important to help assess sepsis risk.

Relevant References: 

Hamilton LF et al. A sterile collection bundle intervention reduces the recovery of bacteria from neonatal culture. Biomed Hub 2018;3:1-7.

Patton RG et al. Innovation for reducing blood culture contamination: initial specimen diversion technique. J Clin Microbiol 2010;48(12):4501-3.

Zimmerman FS et al. Modification of blood test draw order to reduce blood culture contamination: A randomized clinical trial. Clin Infect Dis 2020;71(5):1215-1220.

Allen E et al. A quality improvement initiative to reduce blood culture contamination in the neonatal unit. Pediatric Qual Safety 2021;6(3), e413.

Bram S. Use of a sterile collection process to reduce contaminated peripheral blood cultures. Hosp Pediatrics 2021;11(11), 1205–1216. 

Kuzniewicz MW et al. Time to positivity of neonatal blood cultures for early-onset sepsis. PIDJ 2020;39:634-40.

Singh MP. The practice of blood volume submitted for culture in a neonatal intensive care unit. Arch Dis Child. Fetal and Neonatal Ed, 2020;105(6), 600–604.