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24/7 workflow for bloodstream infection diagnostics in microbiology laboratories: the first step to improve clinical management

  • David Chirio ORCID logo EMAIL logo , Elisa Demonchy , Marion Le Marechal , Alice Gaudart , Romain Lotte , Michel Carles and Raymond Ruimy
Published/Copyright: November 4, 2022
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 61 Issue 2

Abstract

Objectives

We aimed to evaluate the impact of an uninterrupted workflow regarding blood cultures on turnaround time and antibiotic prescription.

Methods

Monomicrobial episodes of bacteremia were retrospectively evaluated before and after a continuous 24/7 workflow was implemented in our clinical microbiology laboratory (pre- and post-intervention periods; PREIP and POSTIP). Primary outcome was the time from specimen collection to the first change in antibiotic therapy. Secondary outcomes included the time from specimen collection to effective antibiotic therapy and to antibiotic susceptibility testing results (or turnaround time), as well as hospital length of stay and all-cause mortality at 30 days.

Results

A total of 548 episodes of bacteremia were included in the final analysis. There was no difference in PREIP and POSTIP regarding patient characteristics and causative bacteria. In POSTIP, the mean time to the first change in antibiotic therapy was reduced by 10.4 h (p<0.001). The time to effective antibiotic therapy and the turnaround time were respectively reduced by 4.8 h (p<0.001) and 5.1 h (p=0.006) in POSTIP. There was no difference in mean hospital length of stay or mortality between the two groups.

Conclusions

Around the clock processing of blood cultures allows for a reduction in turnaround time, which in turn reduces the delay until effective antibiotic therapy prescription.

Keywords: antibiotic therapy; blood culture; turnaround time
Corresponding author: David Chirio, Service de Maladies infectieuses et Tropicales, Hôpital l’Archet 1, CHU de Nice, Nice, France; Université Côte d’Azur, Nice, France; and 151 Route de Saint Antoine, 06200 Nice, France, Phone: +33 4 92 03 54 61, Fax: +33 4 92 03 90 66, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2022-0667).

Received: 2022-07-11
Accepted: 2022-10-13
Published Online: 2022-11-04
Published in Print: 2023-01-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2022-0667
Keywords for this article
antibiotic therapy; blood culture; turnaround time

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Standardization and harmonization in laboratory medicine: not only for clinical chemistry measurands
  4. Mini Review
  5. The effect of the immunoassay curve fitting routine on bias in troponin
  6. Opinion Papers
  7. An overview of the most important preanalytical factors influencing the clinical performance of SARS-CoV-2 antigen rapid diagnostic tests (Ag-RDTs)
  8. Time to address quality control processes applied to antibody testing for infectious diseases
  9. Perspectives
  10. Definition and application of performance specifications for measurement uncertainty of 23 common laboratory tests: linking theory to daily practice
  11. The gaps between the new EU legislation on in vitro diagnostics and the on-the-ground reality
  12. General Clinical Chemistry and Laboratory Medicine
  13. Second-generation Elecsys cerebrospinal fluid immunoassays aid diagnosis of early Alzheimer’s disease
  14. Evaluation of the interchangeability between the new fully-automated affinity chrome-mediated immunoassay (ACMIA) and the Quantitative Microsphere System (QMS) with a CE-IVD-certified LC-MS/MS assay for therapeutic drug monitoring of everolimus after solid organ transplantation
  15. Quantitative detection of anti-PLA2R antibodies targeting different epitopes and its clinical application in primary membranous nephropathy
  16. Reference Values and Biological Variations
  17. A zlog-based algorithm and tool for plausibility checks of reference intervals
  18. Harmonization of indirect reference intervals calculation by the Bhattacharya method
  19. Red blood cell parameters in early childhood: a prospective cohort study
  20. Cancer Diagnostics
  21. Association of circulating free and total oxysterols in breast cancer patients
  22. Effect of short-term storage of blood samples on gene expression in lung cancer patients
  23. Infectious Diseases
  24. Operation Moonshot: rapid translation of a SARS-CoV-2 targeted peptide immunoaffinity liquid chromatography-tandem mass spectrometry test from research into routine clinical use
  25. Seroprevalence of SARS-CoV-2 antibodies in Italy in newborn dried blood spots
  26. Positivization time of a COVID-19 rapid antigen self-test predicts SARS-CoV-2 viral load: a proof of concept
  27. New insights into SARS-CoV-2 Lumipulse G salivary antigen testing: accuracy, safety and short TAT enhance surveillance
  28. Preanalytical stability of SARS-CoV-2 anti-nucleocapsid antibodies
  29. Prognostic value of procalcitonin in cancer patients with coronavirus disease 2019
  30. 24/7 workflow for bloodstream infection diagnostics in microbiology laboratories: the first step to improve clinical management
  31. Diagnostic performance of machine learning models using cell population data for the detection of sepsis: a comparative study
  32. Diagnostic value of procalcitonin, hypersensitive C-reactive protein and neutrophil-to-lymphocyte ratio for bloodstream infections in pediatric tumor patients
  33. Letters to the Editor
  34. Pseudohyponatremia: interference of hyperglycemia on indirect potentiometry
  35. Ligand binding assay-related underestimation of 25-hydroxyvitamin D in pregnant women exaggerates the prevalence of vitamin D insufficiency
  36. Urokinase-type plasminogen activator soluble receptor (suPAR) assay in clinical routine: evaluation one year after its introduction in the high automation corelab of the A. Gemelli hospital
  37. Is this a true lambda free light chain?
  38. Effect of various blood collection tubes on serum lithium and other electrolytes: our perspective from a tertiary healthcare institute
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