The rate of blood culture contamination and common organisms isolated in Malaysian public hospitals

Mokhtar NA 1 , Ting SY 2 , Zainol Abidin NZ 3 , Abdul Hameed A 4 , Mohamed Z 5 , Mustapa NI 6 Show all authors , Ahmad NH 6 , Baharuddin S 3 , Sibalinggam G 7 , Abd Hadi ZL 8 , Zam Z 9 , Mat Nor LA 10 , Situ SF 11 , Sharuddin FD 12 , Mohd Ali AS 13 , Abdullah Azahari N 14 , Rashid R 15 , Syed Omar SS 16 , Othman N 17 , Rasid NR 18 , Thangarajah P 19 , Boon KY 20 , Mohd Said NA 21 , Mohd Zaili MZ 22 , Arba'Eni AH 23 , Baharudin R 24 , Md Noor K 25 , Wan Ismail WA 26 , Heng PY 27 , Ahmad Ghazali WAA 28 , Khamis SN 29 , Baharim H 30

Affiliations 

  • 1 Hospital Teluk Intan, Pathology Department, Perak, Ministry of Health, Malaysia. akmalmmj@gmail.com
  • 2 Clinical Research Centre, Hospital Seri Manjung, Perak, Ministry of Health, Malaysia
  • 3 Hospital Tuanku Ja'afar, Pathology Department, Negeri Sembilan, Ministry of Health, Malaysia
  • 4 Hospital Selayang, Pathology Department, Selangor, Ministry of Health, Malaysia
  • 5 Johor Bahru Public Health Laboratory, Johor, Ministry of Health, Malaysia
  • 6 Hospital Sungai Buloh, Pathology Department, Selangor, Ministry of Health, Malaysia
  • 7 Hospital Tuanku Ampuan Najihah, Pathology Department, Negeri Sembilan, Ministry of Health, Malaysia
  • 8 Hospital Raja Permaisuri Bainun, Pathology Department, Perak, Ministry of Health, Malaysia
  • 9 Hospital Taiping, Pathology Department, Perak, Ministry of Health, Malaysia
  • 10 Hospital Serdang, Pathology Department, Selangor, Ministry of Health, Malaysia
  • 11 Hospital Kajang, Pathology Department, Selangor, Ministry of Health, Malaysia
  • 12 Hospital Tengku Ampuan Rahimah, Pathology Department, Selangor, Ministry of Health, Malaysia
  • 13 Hospital Putrajaya, Pathology Department, Wilayah Persekutuan Putrajaya, Ministry of Health, Malaysia
  • 14 Hospital Raja Perempuan Zainab II, Pathology Department, Kelantan, Ministry of Health, Malaysia
  • 15 Hospital Tanah Merah, Pathology Department, Kelantan, Ministry of Health, Malaysia
  • 16 Hospital Sultan Ismail Petra, Pathology Department, Kelantan, Ministry of Health, Malaysia
  • 17 Hospital Sultanah Nur Zahirah, Pathology Department, Terengganu, Ministry of Health, Malaysia
  • 18 Hospital Kemaman, Pathology Department, Terengganu, Ministry of Health, Malaysia
  • 19 Hospital Melaka, Pathology Department, Melaka, Ministry of Health, Malaysia
  • 20 Hospital Pulau Pinang, Pathology Department, Pulau Pinang, Ministry of Health, Malaysia
  • 21 Hospital Sultanah Bahiyah, Pathology Department, Kedah, Ministry of Health, Malaysia
  • 22 Hospital Queen Elizabeth, Pathology Department, Sabah, Ministry of Health, Malaysia
  • 23 Hospital Umum Sarawak, Pathology Department, Sarawak, Ministry of Health, Malaysia
  • 24 Hospital Tengku Ampuan Afzan, Pathology Department, Pahang, Ministry of Health, Malaysia
  • 25 Hospital Sultan Abdul Halim, Pathology Department, Kedah, Ministry of Health, Malaysia
  • 26 Hospital Kulim, Pathology Department, Kedah, Ministry of Health, Malaysia
  • 27 Hospital Sultanah Aminah, Pathology Department, Johor, Ministry of Health, Malaysia
  • 28 Hospital Segamat, Pathology Department, Johor, Ministry of Health, Malaysia
  • 29 Hospital Tuanku Fauziah, Pathology Department, Perlis, Ministry of Health, Malaysia
  • 30 Hospital Sultanah Fatimah, Pathology Department, Johor, Ministry of Health, Malaysia
Malays J Pathol, 2024 Aug;46(2):307-314.
PMID: 39207008

Abstract

INTRODUCTION: Blood culture contamination remains a dilemma issue in the diagnosis of bloodstream infection. However, to date, there is no national data on blood culture contamination and the common organism isolated in Malaysia. This is a pioneer multi-centre study involving public hospitals with medical microbiologists in Malaysia to determine the blood culture contamination rate and the common organism isolated.

MATERIALS AND METHODS: This retrospective cross-sectional study involved record review of all blood culture results over 9 months period from 1st January 2018 until 30th September 2018 in 27 government hospitals in Malaysia. For each positive culture result, the type of isolated organism was classified to represent true bacteraemia or contamination.

RESULTS: We analysed 448,109 blood culture records from the participating hospitals. The blood culture positivity rate was 12.5% (57395 of 448109) and 25.0% (14367 of 57395) of the positive blood culture represents contamination. The national blood culture contamination rate in Malaysia was 3.2%. The contamination rate in the adult population was significantly higher than the paediatric population (3.6% vs. 2.6%; p<0.001). The blood contamination rate by institution ranged from 1.5% to 6.8%. The most frequently isolated microorganisms in the contaminated cultures were coagulase-negative staphylococci (71.0%).

CONCLUSION: Blood culture contamination is a major issue that warrants priority in recognition, and interventions should be implemented to reduce the blood contamination rate in Malaysia.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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