title: Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central line-associated bloodstream infections.
abstract: BACKGROUND
  A literature search was conducted using keywords for articles published in English from January 1990 to March 2015. Using criteria related to blood culture collection and handling, the search yielded 101 articles. References used also included Microbiology Laboratory standards, guidelines, and textbook information.
  
  
  RESULTS
  The literature identified diverse and complex issues surrounding blood culture practices, including the impact of false-positive results, laboratory definition of contamination, effect on central line-associated bloodstream infection (CLABSI) reporting, indications for collecting blood cultures, drawing from venipuncture sites versus intravascular catheters, selection of antiseptics, use of needleless connectors, inoculation of blood culture bottles, and optimizing program management in emergency departments, education, and implementation of bundled practice initiatives.
  
  
  CONCLUSIONS
  Hospitals should optimize best practice in the collection, handling, and management of blood culture specimens, an often overlooked but essential component in providing optimal care of patients in all settings and populations, reducing financial burdens, and increasing the accuracy of reportable CLABSI. Although universal concepts exist in blood culture practices, some issues require further research to determine benefit. Institutions undertaking a review of their blood culture programs are encouraged to use a checklist that addresses elements that encompass the research contained in this review.
authors: Healthcare Epidemiology Department, Stony Brook University Hospital, Stony Brook, NY. Electronic address: robert.garcia@sbumed.org.
authors: Robert A
authors: RA
authors: Garcia
authors: Department of Pathology, Stony Brook University Hospital, Stony Brook, NY.
authors: Eric D
authors: ED
authors: Spitzer
authors: Blood and Marrow Transplant Program, Stony Brook University Hospital, Stony Brook, NY.
authors: Josephine
authors: J
authors: Beaudry
authors: Nursing Administration, Stony Brook University Hospital, Stony Brook, NY.
authors: Cindy
authors: C
authors: Beck
authors: Stony Brook Cancer Center, Stony Brook University Hospital, Stony Brook, NY.
authors: Regina
authors: R
authors: Diblasi
authors: Department of Laboratories, Stony Brook University Hospital, Stony Brook, NY.
authors: Michelle
authors: M
authors: Gilleeny-Blabac
authors: Cardiac ICU, Stony Brook University Hospital, Stony Brook, NY.
authors: Carol
authors: C
authors: Haugaard
authors: Respiratory Care Unit/Medical ICR, Stony Brook University Hospital, Stony Brook, NY.
authors: Stacy
authors: S
authors: Heuschneider
authors: Healthcare Epidemiology Department, Stony Brook University Hospital, Stony Brook, NY.
authors: Barbara P
authors: BP
authors: Kranz
authors: Cardiothoracic ICU, Stony Brook University Hospital, Stony Brook, NY.
authors: Karen
authors: K
authors: McLean
authors: Pediatrics/PICU, Stony Brook University Hospital, Stony Brook, NY.
authors: Katherine L
authors: KL
authors: Morales
authors: Medical ICU, Stony Brook University Hospital, Stony Brook, NY.
authors: Susan
authors: S
authors: Owens
authors: Surgical Progressive Care Unit, Stony Brook University Hospital, Stony Brook, NY.
authors: Mary E
authors: ME
authors: Paciella
authors: Medical Oncology, Stony Brook University Hospital, Stony Brook, NY.
authors: Edwin
authors: E
authors: Torregrosa
mesh_terms: D016470:Bacteremia / Q000175:diagnosis* / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000175:diagnosis* / Q000517:prevention & control*; D006302:Health Services Research; D006801:Humans; D017410:Practice Guidelines as Topic; D013048:Specimen Handling / Q000379:methods*
keywords: Bacteremia; Blood culture; Blood culture collection; Blood culture contamination; Central line associated bloodstream infection; Venipuncture