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


https://doi.org/10.4081/mm.2016.6127
Vol. 31 No. 3 (2016)
Submitted: 5 July 2016
Accepted: 25 August 2016
Published: 18 October 2016
Turnaround time, Sepsis, Rapid molecular test, Laboratory workflow
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Authors

  • Fabio Arena
    arena_fabio@hotmail.it
    Department of Medical Biotechnologies, University of Siena, Siena; Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI), Italy.
  • Marta Argentieri Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Laboratory Department, Bambino Gesù Children’s Hospital, Rome, Italy.
  • Paola Bernaschi Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Laboratory Department, Bambino Gesù Children’s Hospital, Rome, Italy.
  • Giacomo Fortina Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI), Italy.
  • Vesselina Kroumova Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Infection Control Unit, University Hospital "della Carità", Novara, Italy.
  • Esther Manso Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Laboratory of Microbiology, University-Hospital Agency, Ospedali Riuniti, Umberto I-Lancisi-Salesi, Ancona, Italy.
  • Pier Giorgio Montanera Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Microbiology, Aosta Regional Hospital, Aosta, Italy.
  • Pierluigi Nicoletti Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI), Italy.
  • Patrizia Pecile Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Italy.
  • Mario Rassu Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Microbiology and Virology Unit, San Bortolo Hospital, Vicenza, Italy.
  • Gian Maria Rossolini Department of Medical Biotechnologies, University of Siena; Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Clinical Microbiology and Virology Unit, Florence Careggi University Hospital; Department of Experimental and Clinical Medicine, University of Florence; Don Carlo Gnocchi Foundation, Florence, Italy.
  • Teresa Spanu Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Institute of Microbiology, Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy.
  • Pierangelo Clerici Microbiology Unit, Azienda Socio Sanitaria Territoriale Ovest Milano, Legnano, Italy.
  • Carla Fontana Gruppo di Lavoro Infezioni Paziente Critico, Associazione Microbiologi CLinici Italiani (AMCLI); Clinical Microbiology Laboratories, Tor Vergata University Hospital, Rome, Italy.
Background 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.

Supporting Agencies

NA

Arena, F., Argentieri, M., Bernaschi, P., Fortina, G., Kroumova, V., Manso, E., Montanera, P. G., Nicoletti, P., Pecile, P., Rassu, M., Rossolini, G. M., Spanu, T., Clerici, P., & Fontana, C. (2016). Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015. Microbiologia Medica, 31(3). https://doi.org/10.4081/mm.2016.6127

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