Reduce Patient Safety Risks
Diagnostic error is one of the most significant safety risks in healthcare today and inflicts the most harm.1 A blood culture is the gold standard for the diagnosis of sepsis, which is the number one cause of death and readmissions in U.S. hospitals. Yet, the error rate is unacceptably high– on average 8% of all blood cultures are positive and 40% of positive blood cultures are actually false positive. Therefore, a hospital with a blood culture contamination rate at the 3% national average “benchmark” has a false-positive to positive ratio of 38%.
Your patients – at risk.
With 300 patients impacted at an average sized hospital, over 1.2 million patients a year in the U.S. receive inaccurate blood culture results. These patients are at risk of misdiagnosis for bloodstream infections including sepsis which can lead to unnecessary and inappropriate antibiotic treatment, avoidable tests and procedures, and needless hospitalization.
The majority of patients with a false-positive blood culture are treated with potent broad-spectrum antibiotics and do not have their antibiotic therapy appropriately de-escalated. This subjects the patient to harmful consequences such as antibiotic-resistant infections and C.diff contributing to the global antibiotic resistance crisis. Antibiotic exposure remains the most important risk factor for CDI2 with even a single dose increasing a patient’s risk3.
Additionally, there is a high risk of adverse effects associated with antibiotic toxicity, allergic reactions and acute kidney injury which have long-term effects on renal function and cardiovascular health.
Continued unnecessary treatment extends the patient’s hospitalization time and increases their exposure to HAIs/HACs – the fifth leading cause of death in acute-care hospitals4. They will likely be given additional and repeat tests – and experience the stressful effects of uncertainty regarding their health.
Drive Antimicrobial Stewardship
Antibiotic resistance is a global healthcare crisis. A U.S. federal government directive requires a reduction in inappropriate antibiotic use by 20% for in-patient settings.5 The CDC and The Joint Commission mandate that hospitals must adopt aggressive antimicrobial stewardship practices to improve patient outcomes, reduce microbial resistance, and decrease the spread of multidrug-resistant organisms.
Despite these efforts, broad spectrum antibiotic usage is on the rise.
Reduce Antibiotic Use
Antimicrobial stewardship initiatives are greatly impacted by false-positive blood cultures. Over 1.2 million people have a false positive blood culture in the United States annually, the majority of which are prescribed unnecessary or inappropriate antibiotics. This contributes to the proliferation of antibiotic resistant organisms, and numerous patient safety risks including a significant increase in CDI.
One method to decrease antibiotic use is eliminating unnecessary and inappropriate treatment of patients that have a contaminated blood culture.6 An independent clinical trial results demonstrated a 37% decrease in vancomycin days of therapy, with a P=0.007. By significantly reducing blood culture contamination and false-positive results, patients may be treated with the appropriate antibiotics or de-escalated without delay.
Impact Quality Outcome Measures
On average 60% of a hospital’s reimbursement for service comes from The Centers for Medicare & Medicaid Services (CMS).7 Reimbursement metrics include: the patients’ experience of care, and occurrences of hospital acquired infections (HAIs). Clostridium difficile infection (CDI) is a key component of the NHSN Standard Infection Ratio (SIR) calculation for hospital reimbursement, and it is on the rise. Almost 500,000 patients acquire CDI every year, with 70% linked to an inpatient setting.8 Unnecessary and inappropriate antibiotic usage is the leading contributor to the increase in CDI, with studies showing that 26% of CDI cases could be eliminated with a 30% reduction in broad spectrum antibiotics. The use of Steripath, and significantly reduce false-positive blood cultures, has been shown to reduce antibiotic use. Implementing this technology directly impacts this quality outcome metric, and the health and safety of patients.
Eliminate Unnecessary Reporting
False-positive blood cultures also have a direct impact on central-line associated blood stream infections (CLABSIs) and Methicillin-resistant Staphylococcus aureus (MRSA) reporting and their costly associated penalties. Relying on a diagnostic test with 40% of positive results being false positive can lead to unnecessary reporting.
For a patient with a central venous catheter (CVC), if ONE blood culture bottle becomes positive with a non-common commensal organism such as Enterococci, MRSA, or Candida, it qualifies as a CLABSI under NHSN surveillance definition (LCBI1) and must be reported as a CLABSI.
→ All of these may be a skin contaminant
For any patient, only ONE blood culture bottle needs to become positive with MRSA to qualify as a MRSA bacteremia and must be reported as such.
→ 14% of people have MRSA bacteria on their skin
A goal of zero contaminated blood cultures would eliminate reporting false-positive CLABSI and MRSA. For the annual SIR penalties calculation, this could be the difference in avoiding fines of up to 2% of a hospitals entire annual CMS reimbursement, which can add up to millions of dollars.
Maximize CMS reimbursement.
Reduce risk of penalties.
 Society to Improve Diagnosis in Medicine. https://www.improvediagnosis.org/page/Diagnosis  Reveles, Kelly, PharmD, PhD, UTHSC at San Antonio, American Journal of Infection Control 2014.  Owens, Robert C. Jr., et al, Clin Infect Dis (2008) 46 (Supplement_1): S19-S31.  Mauldin PD, Salgado CD, Hansen IS, et al. Attributable Hospital Cost and Length of Stay Associated with Healthcare-Associated Infections Caused by Antibiotic-resistant Gram-Negative Bacteria. Antimicrob Agents Chemother 2010; 54:109-15.doi:10.1128/AAC.01041-09.  National Action Plan for Combating Antibiotic-Resistant Bacteria. CDC, 2015. https://www.cdc.gov/drugresistance/pdf/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf.  The National Quality Forum Antimicrobial Stewardship Playbook.  60 Things to Know About the Hospital Industry. Becker's Hospital Review, January 14, 2016. Web. https://www.beckershospitalreview.com/lists/50-things-to-know-about-the-hospital-industry-2016.html.  Nearly half a million Americans suffered from Clostridium difficile infections in a single year. CDC, 2015. Web. https://www.cdc.gov/media/releases/2015/p0225-clostridium-difficile.html