None listed
Conditions
Brief summary
Blood cultures remain the gold-standard investigation for the diagnosis of bloodstream infection in patients admitted to intensive care units. National and international guidelines state that blood cultures should be taken by peripheral venesection to avoid contamination. Peripheral venesection in ICU patients is frequently challenging and time-consuming and can represent a burden for the patient (pain, discomfort) and the clinician (an extra lengthy procedure in a busy shift). A recent study conducted in Japan in 2023 found that blood culture contamination rates from arterial samples were non-inferior to contamination rates from peripheral venesection samples, suggesting that taking arterial line samples for blood cultures is a viable strategy. The purpose of this study is to determine whether taking blood samples for bacterial culture from arterial catheters that are already in place in ICU patients has an acceptably low rate of contamination compared to newly taken blood samples from venepuncture (using a needle to take a sample from a vein). A secondary aim is to determine whether arterial blood cultures may also have increased sensitivity for true bacterial infection compared to venepuncture.
Interventions
- When an ICU patient with an arterial line in situ in a study site has blood cultures taken due to suspected bloodstream infection, they will be enrolled in the study
- Two sets of blood cultures will be requested: One set from the arterial line and one from a peripheral venepunture
- Both blood cultures will be taken with aseptic technique
- The timing for taking these blood cultures will be not be mandated for this study, however there will be a recommendation to take blood cultures as a poss
- When an ICU patient with an arterial line in situ in a study site has blood cultures taken due to suspected bloodstream infection, they will be enrolled in the study - Two sets of blood cultures will be requested: One set from the arterial line and one from a peripheral venepunture - Both blood cultures will be taken with aseptic technique - The timing for taking these blood cultures will be not be mandated for this study, however there will be a recommendation to take blood cultures as a possible following the request, as per usual protocol. - The blood cultures will only be used in the final analysis if the arterial line cultures and peripheral line cultures are taken within 6 hours of each other. - The blood culture samples will be sent to the laboratory as part of the usual processes within the hospital. - The name of any microorganism grown in the blood culture, along with date and time of growth will be recorded. - The study will continue until a pre-specified number to culture sets are obtained (484). - Positive blood culture results will be assessed by infectious disease specialists in each study site to determine if results are true positives or false positives (contaminants). - Other data from medical records not immediately relevant for assessing blood cultures will not be obtained. - No follow up data or questionnaires will be performed following the initial blood culture collection, however patients may have further sets of blood cultures taken as part of this study if they meet the relevant criteria.
Sponsors
Department of Critical Care Medicince (Auckland City Hospital)
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Adult patients in ICU with an arterial line in situ who have blood cultures taken for suspected bloodstream infection
Exclusion criteria
- Patients under 16 - Patients with a known allergy to chlorhexidine
Outcome results
None listed