Blood culture practices and J-SIPHE-defined bloodstream infection detection in Japanese acute-care hospitals: a nationwide database study.

BACKGROUND

A quality indicator of ≥45 blood culture sets per 1000 patient-days (PDs) has been proposed for blood culture practice in Japan; however, supporting real-world evidence remains limited. This study evaluated blood culture practices and bloodstream infection (BSI) incidence using a nationwide database.

METHODS

We analyzed data from acute care hospitals with a mean length of stay ≤19 days in the Japan Surveillance for Infection Prevention and Healthcare Epidemiology database from January 2021 to December 2023. Parameters included the number of blood culture submissions per 1000 PDs, multiple-set collection rate, positivity rate, contamination rate, and BSIs per 1000 PDs.

RESULTS

A total of 296 hospitals were included in 2023. The median number of blood culture submissions increased from 14.3 in 2021 to 19.4 in 2023 (p < 0.05), accompanied by an increase in BSIs (1.5 to 2.0 per 1000 PDs; p < 0.05). In contrast, no significant changes were observed in the multiple-set collection rate, positivity rate and contamination rate. Submission volume was positively correlated with BSI incidence (γ = 0.86; p < 0.05). The highest BSI incidence (median, 4.0) was observed in facilities with ≥45 sets per 1000 PDs; however, this did not differ significantly from facilities with 30 to <45 sets (median, 3.4) (p = 1.00).

CONCLUSIONS

Higher blood culture submission volumes may be associated with increased BSI detection in Japan. While ≥45 sets per 1000 PDs may be desirable, achieving at least 30 sets per 1000 PDs may represent a practical benchmark for many institutions.