Assessing a standardized decision-making algorithm for blood culture collection in the intensive care unit

Alana Siev, Elana Levy, Jen Ting Chen, Inessa Gendlina, Austin Saline, Parry Mendapara, Michelle Ng Gong, Ari Moskowitz

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose: Blood cultures are commonly ordered for patients with low risk of bacteremia. Indications for obtaining blood cultures are often broad and ill defined, and decision algorithms for appropriate blood cultures have not been comprehensively evaluated in critically-ill populations. Methods: We conducted a retrospective analysis to assess the frequency of inappropriate blood cultures in the ICUs at Montefiore Medical Center based on an evidence-based guidance algorithm. Blood cultures were reviewed against this algorithm to determine their appropriateness. We calculated the prevalence of inappropriate blood culture and explored the reasons for these collected cultures. Results: 300 patients were randomly selected from an initial cohort of 3370 patients. 294 patients were included and of these, 167 patients had at least 1 blood culture drawn. 125 patients had one or more inappropriate blood culture. 61.4% of blood cultures drawn were assessed to be inappropriate. The most common reason for inappropriate cultures was a culture drawn as a result of isolated fever or leukocytosis. Conclusion: In a cohort of critically-ill patients, inappropriate blood cultures were common. The indications for blood cultures are often not evidence-based, and evidence-based algorithms to guide the collection of blood cultures may offer a way to decrease inappropriate culture orders.

Original languageEnglish (US)
Article number154255
JournalJournal of Critical Care
Volume75
DOIs
StatePublished - Jun 2023

Keywords

  • Blood cultures
  • Fever workup
  • ICU
  • Inappropriate cultures
  • Intensive care

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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