Diagnostic stewardship for optimizing blood culture practices: a systematic review of clinical practice guidelines and evidence-based recommendations.
Maria López-Rodríguez, Ana Álvarez-Fernández, Alex Smithson et al.
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In 30 seconds
This systematic review evaluated clinical practice guidelines and evidence-based recommendations for optimizing blood culture (BC) practices to improve bloodstream infection (BSI) diagnosis. The review included 14 guidelines and 3 systematic reviews, highlighting strong consensus on interventions such as guided testing for sepsis and optimal blood volumes. Key recommendations emphasize the importance of standardized protocols to enhance antimicrobial stewardship.
Key findings
- Testing should be guided by clinical suspicion of sepsis, avoiding routine use in low-yield scenarios.
- Optimal blood volumes for cultures are 8-10 mL per bottle in adults.
- Single-site collections are sufficient for most cases, except for endovascular infections.
- Skin antisepsis with 2% chlorhexidine in 70% alcohol is recommended.
Why it matters
Improving blood culture practices is essential for accurate diagnosis of bloodstream infections, which can lead to better patient outcomes and more effective antimicrobial stewardship. Standardized protocols can reduce pre-analytical errors and enhance the overall quality of care.
What to keep in mind
A key limitation was the heterogeneous reporting formats of the guidelines, complicating direct comparisons.