• Laraine L Washer, Carol Chenoweth, Hae-Won Kim, Mary A M Rogers, Anurag N Malani, James Riddell, Latoya Kuhn, Bernard Noeyack, Harry Neusius, Duane W Newton, Sanjay Saint, and Scott A Flanders.
• Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, Michigan 48109, USA. laraine@med.umich.edu
• Infect Control Hosp Epidemiol. 2013 Jan 1;34(1):15-21.

ObjectiveTo determine relative rates of blood culture contamination for 3 skin antisepsis interventions-10% povidone iodine aqueous solution (PI), 2% iodine tincture (IT), and 2% chlorhexidine gluconate in 70% isopropyl alcohol (CHG)-when used by dedicated phlebotomy teams to obtain peripheral blood cultures.DesignRandomized crossover trial with hospital floor as the unit of randomization.SettingTeaching hospital with 885 beds.PatientsAll adult patients undergoing peripheral blood culture collection on 3 medical-surgical floors from May 2009 through September 2009.InterventionEach antisepsis intervention was used for 5 months on each study floor, with random crossover after a 1-month washout period. Phlebotomy teams collected all peripheral blood cultures. Each positive blood culture was adjudicated by physicians blinded to the intervention and scored as a true positive or contaminated blood culture. The primary outcome was the rate of blood culture contamination for each antisepsis agent.ResultsIn total, 12,904 peripheral blood culture sets were evaluated, of which 735 (5.7%) were positive. There were 98 contaminated cultures, representing 13.3% of all positive cultures. The overall blood culture contamination rate for the study population was 0.76%. Intent-to-treat rates of contaminated blood cultures were not significantly different among the 3 antiseptics ([Formula: see text]), yielding 0.58% with PI (95% confidence interval [CI], 0.38%-0.86%), 0.76% with IT (95% CI, 0.52%-1.07%), and 0.93% with CHG (95% CI, 0.67%-1.27%).ConclusionChoice of antiseptic agent does not impact contamination rates when blood cultures are obtained by a phlebotomy team and should, therefore, be based on costs or preference.Trial RegistrationClinicalTrials.gov identifier: NCT01216761 .

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