The following is a summary of “Assessing a standardized decision-making algorithm for blood culture collection in the intensive care unit,” published in the February 2023 issue of Critical Care by Siev et al.

Blood cultures are frequently prescribed for patients with a low likelihood of developing bacteremia. The criteria for obtaining blood cultures are frequently vague and not well-defined. The efficacy of decision-making algorithms for determining appropriate blood cultures has yet to be thoroughly assessed in critically-ill patient populations. A retrospective analysis was performed to evaluate the occurrence rate of unsuitable blood cultures in intensive care units (ICUs) at Montefiore Medical Center utilizing an algorithm that follows evidence-based guidance. The appropriateness of the blood cultures was assessed using this algorithm. The prevalence of unsuitable blood cultures was determined, and the underlying causes for collecting these cultures were investigated.

A sample of 300 patients was obtained through random selection from an initial cohort of 3,370 patients. A total of 294 individuals were enrolled in the study, of which 167 subjects underwent blood culture collection at least once. About 125 patients exhibited one or more instances of unsuitable blood cultures. A significant proportion of the blood cultures obtained were deemed unsuitable, with a rate of 61.4%. The primary cause of unsuitable cultures was the collection of cultures due to isolated fever or leukocytosis. In addition, the incidence of improper blood cultures was high among severely ill patients. The rationale for obtaining blood cultures is frequently not grounded in evidence, and implementing evidence-based protocols for blood culture collection may provide a means of reducing unwarranted culture requests.

Source: sciencedirect.com/science/article/abs/pii/S0883944123000047