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Licensed Unlicensed Requires Authentication Published by De Gruyter November 4, 2022

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

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.


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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