Prospective Trial of Passive Diversion Device to Reduce Blood Culture Contamination
Sami Arnaout MD1, Richard T Ellison III, MD FIDSA, FSHEA1, Thomas C Greenough MD1, Azalea Wedig BS, CIC1, Michael J Mitchell, MD1, Lauren St. John, B.Math2, and Shannon Stock Ph.D.2
1UMass Chan Medical School, Worcester, MA; 2College of the Holy Cross. Worcester, MA.
Researchers with the University of Massachusetts Chan Medical School documented a clinical study of Kurin blood culture collection sets at UMass Memorial Medical Center. The study summarized the trial data in two ways: when the product was intended to be used and when it was actually used, thereby estimating the role of clinician compliance in the device’s efficacy.
UMass Memorial Medical Center is a three-campus facility with two separate Emergency Departments (ED) based at the two campuses with inpatient units. One campus has a higher level of patient acuity and therefore historically has had much higher rates of blood culture contamination. Both ED sites were involved in the trial, with one ED using Kurin for ten weeks, while the other used their standard collection technique. After a wash out period, the two EDs switched roles.
Approximately 5600 cultures were collected during the trial and about half of those were drawn using a Kurin set. The “observed” contamination rate was reduced from 3% to 1.1% when Kurin was used, representing a 63% decrease. As would be expected, there was no change in true positive rates.
The researchers applied an estimated cost of $7,000 per contaminated culture, yielding a cost savings calculation of $1.8M attributable to the drop in the “observed” rate. Likewise, they reported an increased length of stay of 1.3 days per contaminated culture, which translated to 343 avoided hospital days per year.