Member-related | October 5th, 2021

Contribute to universal blood culture sampling guidelines in neonates and infants!

Share your expertise and contribute to universal blood culture sampling guidelines in neonates and infants!

Although neonatal sepsis is one of the leading causes of global under-five mortality, there are very few recommendations on blood culture sampling methods in neonates. A correct blood culture sampling technique is a major determinant of the quality of blood culture surveillance, but is not easy in neonates and small children. In adults and older children, closed system blood culture sampling with vacuum-tube systems (e.g. butterfly needle connected to vacutainer) are preferred to limit blood culture contamination and biosafety risks.
However, in neonates and small children, aspiration of blood through a vacuum-system is frequently unsuccessful due to venous collapse. Therefore, in neonates and small children, blood cultures are often sampled via open systems, either by dedicated venipuncture or upon insertion of a new peripheral catheter. In addition, various open blood culture techniques exist, e.g. with (broken) conventional hollow bore needles or with needles specifically designed for neonates (Vygon Neosafe needle or Sarstedt microneedle). In the literature, evidence on the best strategy for open blood culture sampling is missing, which probably explains the lack of evidence-based recommendations.

The research unit 'Tropical Bacteriology' at the Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, conducts blood culture surveillance in low- and middle income countries. They are convinced that standardized blood culture sampling procedures should be adapted to the practical challenges, particularly in neonates and children. As a next step, educational videos can help to optimize this important pre-analytical step.

Therefore, the research unit would like to consult physicians, midwives, nurses or anybody else with experience in blood culture sampling in neonates and infants, in order to discuss currently used open blood culture sampling techniques (incl. risks and benefits) and to summarize this information:

- Share local, regional or national recommendations/procedures/practices for blood culture sampling
- Discuss on the following research questions while taking into account the risk of blood culture contamination, user- and patient friendliness and biosafety:

  • Is there any evidence available to can help to select the preferred blood culture sampling technique in neonates and infants?
  • Which of the venipuncture needles should be preferred: a conventional hollow bore needle, a Neosafe needle (Vygon) or a microneedle (Sarstedt)?
  • Would you also recommend blood culture sampling via a peripheral catheter at the moment that this catheter is inserted? If yes, which technique would you use (free flow from the hub in a syringe without plunger or aspiration with syringe and needle from the hub)?
  • Until which age or size are open systems preferred?
  • Should sterile gloves be worn while sampling blood for blood cultures?
  • Can neonatal blood culture sampling by one person or is better to work with an assistant?
  • Which volume of blood should be collected for blood cultures?

The ultimate goal is to summarize this information and formulate blood culture sampling recommendations for neonates and small children via a Delphi method:
- Write generic and validated procedures for open blood culture sampling via venipuncture and, if appropriate, via newly inserted catheter in neonates and small children
- Transform these procedures into educational movies

Are you experienced in blood culture sampling in neonates and infants?
Are you interested in connecting with other experts to discuss common challenges in sampling techniques and provide guidance to optimize blood culture sampling?
Then Please contact the research unit 'Tropical Bacteriology' at the Institute of Tropical Medicine Antwerp via