Compliance of clinical microbiology laboratories with recommendations for the diagnosis of bloodstream infections: Data from a nationwide survey in Italy

Abstract

In 2014, the Italian Working Group for Infections in Critically Ill Patient of the Italian Association of Clinical Microbiologists updated the recommendations for the diagnostic workflow for bloodstream infections (BSI). Two years after publication, a nationwide survey was conducted to assess the compliance with the updated recommendations by clinical microbiology laboratories. A total of 168 microbiologists from 168 laboratories, serving 204 acute care hospitals and postacute care facilities, were interviewed during the period January–October 2016 using a questionnaire consisting of nineteen questions which assessed the level of adherence to various recommendations. The most critical issues were as follows: (a) The number of sets of blood cultures (BC) per 1,000 hospitalization days was acceptable in only 11% of laboratories; (b) the minority of laboratories (42%) was able to monitor whether BCs were over or under‐inoculated; (c) among the laboratories monitoring BC contamination (80%), the rate of contaminated samples was acceptable in only 12% of cases;(d) the Gram‐staining results were reported within 1 hr since BC positivity in less than 50% of laboratories. By contrast, most laboratories received vials within 2–4 hr from withdrawal (65%) and incubated vials as soon as they were received in the laboratory (95%). The study revealed that compliance with the recommendations is still partial. Further surveys will be needed to monitor the situation in the future.

How a laboratory-based antimicrobial resistance (AMR) regional surveillance system can address large-scale and local AMR epidemiology: the MICRO-BIO experience

“…The analysis reveals that there are significant differences in the hospital wards in terms of collecting the correct number of blood culture bottles. Ideally, single blood culture sets should constitute less than 5% of the total ( 14 ).…”

Diagnostic stewardship based on patient profiles: differential approaches in acute versus chronic infectious syndromes

“…Unfortunately, even accelerating and tightly monitoring the pre-analytic and analytic phases [68], blood cultures turnaround-time is often long. In the last decades, the average reporting time of blood cultures results has been significantly shortened by the introduction of blood cultures automated monitoring systems and MALDI-TOF-based microbial identification [69,70]. Together with these two technologies, several other mRDT are currently revolutionizing clinical microbiology.…”