Improved blood culture workflow in the time to detection of microorganisms placing incubators systems outside of microbi
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CLINICAL MICROBIOLOGY - RESEARCH PAPER
Improved blood culture workflow in the time to detection of microorganisms placing incubators systems outside of microbiology laboratory M. Angeles Orellana 1,2
&
Fernando Chaves 1,2 & Rafael Delgado 1,2
Received: 16 January 2020 / Accepted: 12 May 2020 # Sociedade Brasileira de Microbiologia 2020
Abstract Purpose We analyzed the workflow of the blood culture procedure with one blood culture incubator in the microbiology laboratory, in comparison with the workflow with the incubators systems placing outside, and in a microbiology laboratory without 24-h staffing. Methods We assessed the elapsed time (ET) and time-to-result (TTR) in the two laboratory workflows during 1 month period in consecutive years. First period with one BACT/ALERT 3D module located in the microbiology laboratory (ML) (access 8 a.m. to 10 p.m.) and second period with three BACT/ALERT VIRTUO modules (one located in ML and two in the core sample laboratory, access 24 h). Results The mean ET with BACT/ALERT 3D was 7.09 ± 6.15 h and 1.32 ± 3.14 h with BACT/ALERT VIRTUO. During the 8:00 a.m. to 10:00 p.m. shift, the average ETs were 3.54 ± 5.06 vs 1.59 ± 1.29 h for the two time periods, respectively. Since the automated loading of bottles on the BACT/ALERT VIRTUO allows processing of blood cultures during the night shift, there was a significant reduction of time during the 10:00 p.m. to 8:00 a.m. shift, where the average ET was 10.52 ± 5.23 vs 1.00 ± 4.40 h, respectively. The percentage of positivity in the first period was 9.03% and 11.18% in the second (p = 0.0003). The average TTR in the first period was 24.78 ± 15.9 h and 16.85 ± 14.13 h in the second (p < 0.0001). Conclusions Easy 24-h access to blood culture incubators resulted in significant improvement in the workflow of blood culture, decreasing ET, and therefore decreasing the time to positivity and the efficiency of recovery. Keywords Workflow blood culture . Bloodstream infections . Elapsed time . Blood culture incubator
Introduction Bloodstream infections (BI) have a significant impact on morbidity, mortality rates, and hospital costs [1]. Worldwide, the mortality associated with nosocomial BI remains high and varies from 30.5 to 55% [2]. Blood culture is considered the “gold standard” and is the most important diagnostic tool for the detection of BI [3]. It has been previously reported that a Responsible Editor: Afonso Luis Barth. * M. Angeles Orellana [email protected] 1
Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
2
Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, España
decrease in the time between the collection of blood cultures and the notification of culture results is associated with a reduction in the time to optimal antimicrobial therapy and deescalation and an improvement in the care of patients with an associated decrease in hospital costs [1, 4]. Improving the time to detection of microorganisms is crucial to perform identification and determi
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