Successful Reduction of Blood Culture Contamination in an Emergency Department by Monitoring and Feedback

Arif M. Al-Hamad1, *
1 Division of Clinical Microbiology, Pathology and Laboratory Medicine, Qatif Central Hospital, Qatif 31911, Saudi Arabia



Blood Culture (BC) contamination is a common problem in the Emergency Department (ED) and is associated with prolonged length of patient stay and excess costs.


The study aimed to investigate the impact of monthly monitoring and feedback of BC results on contamination rates.


Data from a previous study showed that the contamination rate in the ED consistently exceeded the recommended level. This triggered an ad hoc Quality Improvement team to develop and implement a corrective action plan. In 2017, BC contamination rates were reported to the ED on a monthly basis. In response to this, ED staff conducted intensified educational workshops, followed by private counselling and competency assessment of nurses who collected contaminated BCs.


A total of 12 educational workshops were conducted in February and March, 2017. The intervention resulted in >60% reduction in the contamination rate, from 8.6% baseline level to less than 3%. Of the 2660 BC sets drawn in 2017 from 1318 patients, 128 (4.8%) were contaminated, accounting for 39.5% of the total number of positive cultures. Sixty percent of the contaminated BCs grew Coagulase-negative Staphylococcus species; other contaminants included Corynebacterium spp., Micrococcus spp., Propionibacterium spp., viridans Streptococcus, and Neisseria spp.


Continuous monitoring and feedback of contamination rates reduced BC contamination.

Keywords: Pseudobacteremia, Aseptic technique, Phlebotomy team, Hospital stay, Antibiotic use, Hospital cost.

Abstract Information

Identifiers and Pagination:

Year: 2019
Volume: 13
Publisher Item Identifier: EA-TOMICROJ-2019-17

Article History:

Received Date: 03/06/2019
Revision Received Date: 25/09/2019
Acceptance Date: 28/09/2019
Electronic publication date: 25/10/2019
Collection year: 2019

© 2019 Arif M. Al-Hamad

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Division of Clinical Microbiology, Pathology and Laboratory Medicine, Qatif Central Hospital, PO Box 18476, Qatif 31911, Saudi Arabia; Tel: +966 (13) 8361000 Ex. 4306; Fax: +966 (13) 8360040; E-mail: