Category: Fellows Posters
To determine if the initiation of a code sepsis protocol had an impact on unnecessary antibiotic treatment of contaminated blood cultures in a community hospital. With the implementation of Centers for Medicare and Medicaid Services quality initiatives regarding sepsis early management, one of the bundle requirements includes two sets of blood cultures prior to antimicrobial therapy. Increasing blood cultures drawn in a facility potentially increases rates of contamination. Contaminated blood cultures have been shown to increase cost, hospital-acquired conditions, and length of stay. This study will explore antibiotic usage and adverse medication events associated with contaminated blood cultures.
This is a retrospective, observational, single-center study that will be submitted to the Institutional Review Board for approval. Infection prevention and control records will identify patients with contaminated blood cultures before and after initiation of a code sepsis protocol (October 17, 2017). The following data will be collected: age, gender, sex, weight, height, antibiotic usage (agent/days of therapy), serum creatinine, number of positive blood culture vials, type of blood culture, bacteria grown, other culture results, infectious disease consult status, and Clostridium difficile infection within 30 days of discharge. Study groups will include patients with contaminated blood cultures pre and post-code sepsis implementation. Patients will be included if 18 years or older and have positive blood culture deemed contaminated by infection prevention and control. Patients will be excluded if they are immunocompromised or if antibiotic therapy was continued per infectious disease physician consult within 48 hours of positive culture. The primary outcome is total days of antibiotic therapy. Secondary outcomes include total number of antibiotics, total rate of contaminated blood cultures, incidence of nephrotoxicity, incidence of Clostridium difficile, associated physician consult costs, and rates of blood culture types.