Universität zu Köln

Walker, Sarah, V, Steffens, Benedict, Sander, David and Wetsch, Wolfgang A. ORCID: 0000-0001-5800-6665 (2022). Implementation of Antibiotic Stewardship Improves the Quality of Blood Culture Diagnostics at an Intensive Care Unit of a University Hospital. J. Clin. Med., 11 (13). BASEL: MDPI. ISSN 2077-0383

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Abstract

Background: Bloodstream infections increase morbidity and mortality in hospitalized patients and pose a significant burden for health care systems worldwide. Optimal blood culture diagnostics are essential for early detection and specific treatment. After assessing the quality parameters at a surgical intensive care unit for six months, we implemented a diagnostic stewardship bundle (DSB) to optimize blood culture diagnostics and then reevaluated its effects after six months. Material and Methods: All patients >= 18 years old and on the ward were included: pre-DSB 137 and post-DSB 158. The standard quality parameters were defined as the number of blood culture sets per diagnostic episode (>= 2), the rate of contamination (2-3%), the rate of positivity (5-15%), the collection site (>= 1 venipuncture per episode) and the filling volume of the bottles (8-10 mL, only post-DSB). The DSB included an informational video, a standard operating procedure, and ready-to-use paper crates with three culture sets. Results: From pre- to post-interventional, the number of >= 2 culture sets per episode increased from 63.9% (257/402) to 81.3% (230/283), and venipunctures increased from 42.5% (171/402) to 77.4% (219/283). The positivity rate decreased from 15.1% (108/714) to 12.8% (83/650), as did the contamination rate (3.8% to 3.6%). The majority of the aerobic bottles were filled within the target range (255/471, 54.1%), but in 96.6%, the anaerobic bottles were overfilled (451/467). Conclusions: The implementation of DSB improved the quality parameters at the unit, thus optimizing the blood culture diagnostics. Further measures seem necessary to decrease the contamination rate and optimize bottle filling significantly.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Walker, Sarah, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffens, Benedict UNSPECIFIED UNSPECIFIED UNSPECIFIED Sander, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Wetsch, Wolfgang A. UNSPECIFIED orcid.org/0000-0001-5800-6665 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-669597
DOI:	10.3390/jcm11133675
Journal or Publication Title:	J. Clin. Med.
Volume:	11
Number:	13
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2077-0383
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONTAMINATION; THERAPY Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66959