TABLE 1.

Addressing the challenge of blood culture contamination

ApproachRationale
Detecting contaminantsGiven that contamination can likely never be eliminated, having reliable factors to help identify true positives vs false positives is critical for patient management and population-based surveillance
PreventionReducing contamination rates will improve the specificity of the blood culture and result in a higher PPV, resulting in a significantly more useful test
Supporting optimal use of blood culturesReducing the use of blood cultures in patients with a very low likelihood of bacteremia will result in a higher PPV and reduced costs associated with contamination; pretest probability of bacteremia can be estimated using population-based studies of disease prevalence or clinical prediction rules