Blood cultures: changing needles between inoculation decreased contamination.

Clinical bottom line (level 2a)

  1. When inoculating blood cultures, changing the needle led to less contamination than not changing the needle.
Spitalnic et al: Clinical Infectious Diseases 1995; 21: 1183-1186
Expires October 2003

The study

Systematic review of prospective, controlled studies of
  • Patients: inoculating blood cultures taken directly by venipuncture
  • Intervention: needle change compared with no needle change
  • Outcome: contamination


    • Articles found in English using MEDLINE, 1966 to 1994 (search terms: blood culture ) and references from review articles were searched, as were references from clinical microbiology and clinical procedure texts

    Selection criteria: as above
    Appraisal criteria: not detailed
    Articles excluded if:

    eight published studies were included (three of them were randomised)

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    contamination unknown 136
    (6.87%)    		 100
    (4.41%)    		 36%
    (17% to 50%)    		 2.46%
    (1.06% to 3.85%)    		 41
    (26 to 94)

    Comments

    1. The risk of needlestick injury must be considered, taking into special consideration the available resheathing needles.

    Citation

    1. Spitalnic SJ, Woolard RH, Mermel LA: the significance of changing needles when inoculating blood cultures: a meta-analysis. Clinical Infectious Diseases 1995; 21: 1183-1186
    Contributor: Chris Ball and Clare Wotton, October 2000
    Reviewer: William Rhoton

    Clinical Question.
    Patient inoculating blood cultures
    Intervention or Exposure needle change
    Comparison no needle change
    Outcome contamination