Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015

Abstract

SummaryBackground and aims: Blood culture (BC) results are essential to guide antimicrobial chemotherapy for patients with sepsis. However, BC is a time-consuming exam, which can take several days. Reducing BCs turn around time (TAT) could impact on multiple outcome parameters and TAT monitoring is an important tool for measurement of microbiology laboratory performance. The aim of this study was to provide an overview of BC TATs among Italian microbiology laboratories.Materials and methods: Five laboratories collected and recorded, for a month period, date and time of the BC processing events. Cumulative TATs were analysed using the GraphPad software.Results: Participating laboratories reported data from 302 sepsis episodes. The median time from when the BC system produced a positive signal until Gram-stain results were reported was 7.6 hours. A rapid molecular identification and antimicrobial susceptibility testing (AST) was performed in 26.5% of BCs. Mean TAT for identification report was significantly lower when a molecular approach was adopted (12 vs. 28.7 hours, P<0.001). Similarly, results of the molecular AST were obtained more than 24 hours in advance compared with phenotypic AST (mean 13.2 vs. 47.6, P<0.001). TATs from BC positivity of laboratories opened 7 days/week were not significantly lower than those of laboratories opened 6 days/week.Conclusions: BC is a time-consuming exam, however, molecular identification and AST methods can drastically reduce time to results. The lack of difference between TATs observed for laboratories working 7 days/week and 6 days/week, coupled with a high rate of BCs turning positive during the night enable to conclude that the most urgent measure to reduce TATs is the expansion of laboratory regular duty hours. IntroductionSepsis is a severe disease associated with high morbidity and mortality (7). Although conflicting data exist, early administration of appropriate empirical antimicrobial therapy, coupled with supportive treatment, have been shown to have an important impact on outcome (6,9,10,16

Microbiological diagnostics of bloodstream infections in Europe—an ESGBIES survey

“…Some rapid diagnostic technologies, e.g. molecular methods [7] and rapid culture methods supported by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) [13] have been suggested to speed up microbiological BSI diagnosis [1,2,4], but data about their use and acceptance in routine practice are lacking [14,15]. The transportation time of microbiological specimens is an underestimated pre-analytical factor, which is critical for the clinical impact of microbiological diagnostics, in particular if rapid tests are applied [8,16e19].…”

Diagnostic and antibiotic use practices among COVID-19 and non-COVID-19 patients in the Indonesian National Referral Hospital

“…We observed a longer median BC turn-around time compared to those reported in highincome countries, i.e. 2-3 days [26][27][28]. The BC turn-around time is critical for gaining the maximum benefits of BC as a guidance for clinicians in deciding rational antibiotic prescriptions, reduce length of hospitalization and increase patient survival [4,[29][30][31][32][33].…”

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

“…In an era of remarkable technology innovation in clinical microbiology, a drastic reduction of reporting times is possible (Arena et al, ; Özenci & Rossolini, ). In this perspective, it is noteworthy that most laboratories were unable to answer question no.…”