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Published in: Infection 4/2017

01-08-2017 | Original Paper

Deficits in knowledge, attitude, and practice towards blood culture sampling: results of a nationwide mixed-methods study among inpatient care physicians in Germany

Authors: Heike Raupach-Rosin, Arne Duddeck, Maike Gehrlich, Charlotte Helmke, Johannes Huebner, Mathias W. Pletz, Rafael Mikolajczyk, André Karch

Published in: Infection | Issue 4/2017

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Abstract

Purpose

Blood culture (BC) sampling rates in Germany are considerably lower than recommended. Aim of our study was to assess knowledge, attitudes, and practice of physicians in Germany regarding BC diagnostics.

Methods

We conducted a cross-sectional mixed-methods study among physicians working in inpatient care in Germany. Based on the results of qualitative focus groups, a questionnaire-based quantitative study was conducted in 2015–2016. In total, 706 medical doctors and final-year medical students from 11 out of 16 federal states in Germany participated.

Results

BC sampling was considered an important diagnostic tool by 95% of the participants. However, only 23% of them would collect BCs in three scenarios for which BC ordering is recommended by present guidelines in Germany; almost one out of ten physicians would not have taken blood cultures in any of the three scenarios. The majority of participants (74%) reported not to adhere to the guideline recommendation that blood culture sampling should include at least two blood culture sets from two different injection sites. High routine in blood culture sampling, perceived importance of blood culture diagnostics, the availability of an in-house microbiological lab, and the department the physician worked in were identified as predictors for good blood culture practice.

Conclusion

Our study suggests that there are substantial deficits in BC ordering and the application of guidelines for good BC practice in Germany. Based on these findings, multimodal interventions appear necessary for improving BC diagnostics.
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Literature
1.
2.
go back to reference Fleischmann C, Thomas-Rueddel DO, Hartmann M, Hartog CS, Welte T, Heublein S, et al. Hospital incidence and mortality rates of sepsis. Deutsches Arzteblatt Int. 2016;113:159–66. doi:10.3238/arztebl.2016.0159. Fleischmann C, Thomas-Rueddel DO, Hartmann M, Hartog CS, Welte T, Heublein S, et al. Hospital incidence and mortality rates of sepsis. Deutsches Arzteblatt Int. 2016;113:159–66. doi:10.​3238/​arztebl.​2016.​0159.
5.
go back to reference Seifert H, Abele-Horn M, Fätkenheuer G, Glück T, Jansen B, Kern WV et al. Blutkulturdiagnostik. Sepsis, Endokarditis, Katheterinfektionen, Teil I. München: Urban & Fischer Verlag; 2007. Seifert H, Abele-Horn M, Fätkenheuer G, Glück T, Jansen B, Kern WV et al. Blutkulturdiagnostik. Sepsis, Endokarditis, Katheterinfektionen, Teil I. München: Urban & Fischer Verlag; 2007.
12.
go back to reference Ojide C, Onwuezobe IA, Asuquo EE, Obiagwu CS. Knowledge, attitude and practice of blood culture: a cross sectional study among medical doctors in a Nigerian tertiary hospital. Afr J Clin Exp Microbiol. 2013;14:6. Ojide C, Onwuezobe IA, Asuquo EE, Obiagwu CS. Knowledge, attitude and practice of blood culture: a cross sectional study among medical doctors in a Nigerian tertiary hospital. Afr J Clin Exp Microbiol. 2013;14:6.
13.
go back to reference Chew KS, Mohd Hashairi F, Jusoh AF, Aziz AA, Nik Hisamuddin NA, Siti AH. Knowledge of good blood culture sampling practice among healthcare staffs in an emergency department: are we getting it right? Med J Malays. 2013;68:323–5. Chew KS, Mohd Hashairi F, Jusoh AF, Aziz AA, Nik Hisamuddin NA, Siti AH. Knowledge of good blood culture sampling practice among healthcare staffs in an emergency department: are we getting it right? Med J Malays. 2013;68:323–5.
14.
go back to reference Creswell JW, Plano Clark VL, Gutmann ML, Hanson WE. Advanced mixed methods research designs. Handbook of mixed methods in social and behavioral research Thousands Oaks, CA: Sage; 2003. Creswell JW, Plano Clark VL, Gutmann ML, Hanson WE. Advanced mixed methods research designs. Handbook of mixed methods in social and behavioral research Thousands Oaks, CA: Sage; 2003.
15.
go back to reference Krueger RA, Casyey MA. Focus Groups. A practical guide for Applied Research. 4th Edition. Thousands Oaks: Sage: 2009. Krueger RA, Casyey MA. Focus Groups. A practical guide for Applied Research. 4th Edition. Thousands Oaks: Sage: 2009.
16.
go back to reference Mayring P. Qualitative Inhaltsanalyse. Grundlagen und Techniken. 11., aktualisierte und überarbeitete Auflage. Weinheim und Basel: Beltz; 2010. Mayring P. Qualitative Inhaltsanalyse. Grundlagen und Techniken. 11., aktualisierte und überarbeitete Auflage. Weinheim und Basel: Beltz; 2010.
17.
go back to reference Schmitz RP, Keller PM, Baier M, Hagel S, Pletz MW, Brunkhorst FM. Quality of blood culture testing - a survey in intensive care units and microbiological laboratories across four European countries. Crit Care. 2013;17:R248. doi:10.1186/cc13074.CrossRefPubMedPubMedCentral Schmitz RP, Keller PM, Baier M, Hagel S, Pletz MW, Brunkhorst FM. Quality of blood culture testing - a survey in intensive care units and microbiological laboratories across four European countries. Crit Care. 2013;17:R248. doi:10.​1186/​cc13074.CrossRefPubMedPubMedCentral
22.
go back to reference Karch A, Schmitz RP, Rissner F, Castell S, Topel S, Jakob M, et al. Bloodstream infections, antibiotic resistance and the practice of blood culture sampling in Germany: study design of a Thuringia-wide prospective population-based study (AlertsNet). BMJ Open. 2015;5:e009095. doi:10.1136/bmjopen-2015-009095.CrossRefPubMedPubMedCentral Karch A, Schmitz RP, Rissner F, Castell S, Topel S, Jakob M, et al. Bloodstream infections, antibiotic resistance and the practice of blood culture sampling in Germany: study design of a Thuringia-wide prospective population-based study (AlertsNet). BMJ Open. 2015;5:e009095. doi:10.​1136/​bmjopen-2015-009095.CrossRefPubMedPubMedCentral
23.
go back to reference Reichardt C, Koniger D, Bunte-Schonberger K, van der Linden P, Monch N, Schwab F, et al. Three years of national hand hygiene campaign in Germany: what are the key conclusions for clinical practice? J Hosp Infect. 2013;83:S11–6. doi:10.1016/S0195-6701(13)60004-3.CrossRefPubMed Reichardt C, Koniger D, Bunte-Schonberger K, van der Linden P, Monch N, Schwab F, et al. Three years of national hand hygiene campaign in Germany: what are the key conclusions for clinical practice? J Hosp Infect. 2013;83:S11–6. doi:10.​1016/​S0195-6701(13)60004-3.CrossRefPubMed
28.
go back to reference Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA, J Am Med Assoc. 2016;315:762–74. doi:10.1001/jama.2016.0288.CrossRef Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA, J Am Med Assoc. 2016;315:762–74. doi:10.​1001/​jama.​2016.​0288.CrossRef
Metadata
Title
Deficits in knowledge, attitude, and practice towards blood culture sampling: results of a nationwide mixed-methods study among inpatient care physicians in Germany
Authors
Heike Raupach-Rosin
Arne Duddeck
Maike Gehrlich
Charlotte Helmke
Johannes Huebner
Mathias W. Pletz
Rafael Mikolajczyk
André Karch
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 4/2017
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-017-0990-7

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