title: Effect of routine sterile gloving on contamination rates in blood culture: a cluster randomized trial.
abstract: BACKGROUND
  Blood culture contamination leads to inappropriate or unnecessary antibiotic use. However, practical guidelines are inconsistent about the routine use of sterile gloving in collection of blood for culture.
  
  
  OBJECTIVE
  To determine whether the routine use of sterile gloving before venipuncture reduces blood culture contamination rates.
  
  
  METHODS
  Cluster randomized, assessor-blinded, crossover trial (ClinicalTrials.gov registration number: NCT00973063).
  
  
  METHODS
  Single-center trial involving medical wards and the intensive care unit.
  
  
  METHODS
  64 interns in charge of collection of blood for culture were randomly assigned to routine-to-optional or optional-to-routine sterile gloving groups for 1854 adult patients who needed blood cultures.
  
  
  METHODS
  During routine sterile gloving, the interns wore sterile gloves every time before venipuncture, but during optional sterile gloving, sterile gloves were worn only if needed.
  
  
  METHODS
  Isolates from single positive blood cultures were classified as likely contaminant, possible contaminant, or true pathogen. Contamination rates were compared by using generalized mixed models.
  
  
  RESULTS
  A total of 10 520 blood cultures were analyzed: 5265 from the routine sterile gloving period and 5255 from the optional sterile gloving period. When possible contaminants were included, the contamination rate was 0.6% in routine sterile gloving and 1.1% in optional sterile gloving (adjusted odds ratio, 0.57 [95% CI, 0.37 to 0.87]; P = 0.009). When only likely contaminants were included, the contamination rate was 0.5% in routine sterile gloving and 0.9% in optional sterile gloving (adjusted odds ratio, 0.51 [CI, 0.31 to 0.83]; P = 0.007).
  
  
  CONCLUSIONS
  Blood cultures from the emergency department, surgical wards, and pediatric wards were not assessed.
  
  
  CONCLUSIONS
  Routine sterile gloving before venipuncture may reduce blood culture contamination.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Chongro-Gu, Seoul, Republic of Korea.
authors.forename: Nak-Hyun
authors.initials: NH
authors.lastname: Kim
authors.forename: Moonsuk
authors.initials: M
authors.lastname: Kim
authors.forename: Shinwon
authors.initials: S
authors.lastname: Lee
authors.forename: Na Ra
authors.initials: NR
authors.lastname: Yun
authors.forename: Kye-Hyung
authors.initials: KH
authors.lastname: Kim
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Park
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
authors.forename: Nam-Joong
authors.initials: NJ
authors.lastname: Kim
authors.forename: Eui-Chong
authors.initials: EC
authors.lastname: Kim
authors.forename: Wan Beom
authors.initials: WB
authors.lastname: Park
authors.forename: Myoung-Don
authors.initials: MD
authors.lastname: Oh
mesh_terms: D001407:Bacillus / Q000302:isolation & purification; D001431:Bacteriological Techniques / Q000592:standards; D001769:Blood / Q000382:microbiology*; D017848:Blood-Borne Pathogens; D018592:Cross-Over Studies; D004203:Disinfection / Q000379:methods / Q000592:standards; D016983:Enterococcus / Q000302:isolation & purification; D005189:False Positive Reactions; D005932:Gloves, Surgical; D019983:Guideline Adherence; D006748:Hospital Departments; D006801:Humans; D018962:Phlebotomy / Q000009:adverse effects / Q000379:methods* / Q000592:standards*; D011446:Prospective Studies; D016037:Single-Blind Method; D013210:Staphylococcus / Q000302:isolation & purification