A Sterile Collection Bundle Intervention Reduces the Recovery of Bacteria from Neonatal Blood Culture

BACKGROUND: In neonatal intensive care, coagulase-negative Staphylococcus species can be both blood culture contaminants and pathogens. False-positive cultures can result in clinical uncertainty and unnecessary antibiotic use. OBJECTIVE: This study sought to assess whether a sterile blood culture collection bundle would reduce the incidence of false-positive blood cultures in a regional neonatal intensive care unit. METHOD: Clinical data was collected from all infants who had blood cultures taken before and after the introduction of the sterile blood culture collection bundle intervention. This intervention required 2% chlorhexidine and full sterile precautions for blood culture collection. False-positive blood culture rates (presence of skin commensals and ≥3 clinical infection signs) were compared before and after the intervention. The number of days of unnecessary antibiotics associated with false-positive blood cultures was also analysed. RESULTS: In the pre-intervention group (PRE) 197 cultures were taken from 161 babies. In the post-intervention group (POST) 170 cultures from 133 babies were acquired. Baseline demographics were similar in both groups. The rate of false-positive cultures in the PRE group versus the POST group was 9/197 (4.6%) compared to 1/170 (0.6%) (p < 0.05). Unnecessary antibiotic exposure was reduced in the PRE group in comparison to the POST group (27 vs. 0 days, p < 0.01). CONCLUSIONS: Implementation of sterile blood culture collection intervention reduced the number of false-positive results. This has potential benefit in reducing unnecessary antibiotic use.