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Ann Intern Med. 2011 Feb 1;154(3):145-51. doi: 10.7326/0003-4819-154-3-201102010-00003.

Effect of routine sterile gloving on contamination rates in blood culture: a cluster randomized trial.

Author information

1
Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Chongro-Gu, Seoul, Republic of Korea.

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.

DESIGN:

Cluster randomized, assessor-blinded, crossover trial (ClinicalTrials.gov registration number: NCT00973063).

SETTING:

Single-center trial involving medical wards and the intensive care unit.

PARTICIPANTS:

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.

INTERVENTION:

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.

MEASUREMENTS:

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).

LIMITATION:

Blood cultures from the emergency department, surgical wards, and pediatric wards were not assessed.

CONCLUSION:

Routine sterile gloving before venipuncture may reduce blood culture contamination.

[Indexed for MEDLINE]

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