Indagine nazionale sulle metodiche per emocoltura in Italia

Sepsis is an important cause of morbidity and mortality; Blood cultures are the standard for identifying the responsible pathogen, bacteria or fungi.A number of factors influence the yield of blood culture, most of them concerning the microbiolist skill and the laboratory organization. In order to collect information about the practices and procedures used for the detection of microrganisms in blood cultures in the italian laboratory, a questionnaire was sent to all the 2000 members of the Italian Association of Clinical Microbiology. Responses were received from 110 laboratories, located from all over the country (2.028.581 hospital admission).The results presented hereby concern specimen collection, culture techniques, rapid identification and susceptibility testing. In summary, most laboratories use automated systems (83.6%), the lenght of incubation was 7 days in two out of three laboratories, although it is common to extend the incubation period when brucellosis (83 lab), endocarditis (47 lab), systemic mycosis (27 lab) is suspected.A wide variety of media are employed for subcultures. All laboratories examine the bottles at least once a day, while only 32 of 95 (33.7%) laboratories processe the positive blood cultures on holiday. Communication between clinicians and microbiologist include: distribution of specimen collection guidelines by 93 (84.5%) laboratories, availability of patients’ clinical situation in 35 (32.4%) laboratories, and adding to report the suggestion of potentialy contaminated culture (i.e.“a positive results does not necessarly indicate bacteremias”) in 31 (28.4%). Only laboratories perform direct, tests 18.6% antimicrobial susceptibility test, and 9.3% perform rapid direct identification.