Graduation Date

Spring 5-8-2021

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Epidemiology

First Advisor

Lorena Baccaglini

Second Advisor

Gleb Haynatzki

Third Advisor

Sharon Medcalf

Fourth Advisor

Mark Rupp

Abstract

Blood cultures are the gold standard for detecting blood stream infections. However, in the US, 0.6-6% of all blood cultures get contaminated leading to adverse clinical outcomes such as unnecessarily prolonged hospital stay and antibiotic therapy. Using electronic medical records, we explored the clinical outcomes and patient-specific risk factors of contaminated blood cultures in an era where rapid blood culture testing was being utilized to provide blood culture results within hours. Rapid blood culture test results can help clinicians in early and more effective management of patients with contaminated blood cultures, thus improving clinical outcomes. We also studied the impact of rapid blood culture testing on clinical outcomes by comparing clinical outcomes before and after the implementation of rapid testing.

Results of the first study relate that contaminated blood cultures continue to have a significant effect on duration of hospital stay and antibiotic therapy. The second study indicated that patients with chronic obstructive pulmonary disease, and ICU stay during hospitalization, were at higher odds of experiencing blood culture contamination. The last study showed that rapid blood culture testing did not affect clinical outcomes in patients with contaminated blood cultures.

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