• C L Strand, R R Wajsbort, and K Sturmann.
• Department of Pathology, Beth Israel Medical Center, Mount Sinai School of Medicine, New York, NY.
• JAMA. 1993 Feb 24; 269 (8): 1004-6.

ObjectiveTo determine if iodine tincture is a more effective skin antiseptic for blood culture collection than povidone-iodine, an iodophor.DesignPairwise comparisons across phases. In phases 1 and 3, blood culture skin preparation was performed with the iodophor; in phases 2 and 4, skin preparation was performed with iodine tincture.SettingEmergency department of a large urban teaching hospital.PatientsAll adult patients seen in the emergency department who had blood cultures collected because a systemic bacterial infection was suspected.Main Outcome MeasureThe blood culture contamination rate for the iodophor and iodine tincture skin preparations.ResultsA total of 8467 blood cultures were collected during the study, and 421 (4.97%) were classified as contaminated. The contamination rate for the blood cultures collected using the iodophor was 6.25%, and the contamination rate for the cultures using iodine tincture was 3.74%; this difference is statistically significant (P < .00001).ConclusionsThe effectiveness of the skin antiseptic may be an important factor in determining contamination rate in blood culturing. If these results are confirmed by others, then institutions that have a high blood culture contamination rate when using an iodophor for skin preparation should consider changing to iodine tincture.

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