Abstract
ObjectivesAccurate and rapid microbiological diagnostics are crucial to tailor treatment and improve outcomes in patients with severe infections. This study aimed to assess blood culture diagnostics in the Nordic countries and to compare them with those of a previous survey conducted in Sweden in 2013. MethodsAn online questionnaire was designed and distributed to the Nordic clinical microbiology laboratories (CMLs) (n = 76) in January 2018. ResultsThe response rate was 64% (49/76). Around-the-clock incubation of blood cultures (BCs) was supported in 82% of the CMLs (40/49), although in six of these access to the incubators around the clock was not given to all of the cabinets in the catchment area, and 41% of the sites (20/49) did not assist with satellite incubators. Almost half (49%, 24/49) of the CMLs offered opening hours for ≥10 h during weekdays, more commonly in CMLs with an annual output ≥30 000 BCs. Still, positive BCs were left unprocessed for 60–70% of the day due to restrictive opening hours. Treatment advice was given by 23% of CMLs (11/48) in ≥75% of the phone contacts. Rapid analyses (species identification and susceptibility testing with short incubation), performed on aliquots from positive cultures, were implemented in 18% of CMLs (9/49). Compared to 2013, species identification from subcultured colonies (<6 h) had become more common. ConclusionsCMLs have taken action to improve aspects of BC diagnostics, implementing satellite incubators, rapid species identification and susceptibility testing. However, the limited opening hours and availability of clinical microbiologists are confining the advantages of these changes.
Highlights
Modern healthcare systems depend on rapid and accurate diagnostics to optimize in-hospital care and reduce costs [1]
The proportion of responding clinical microbiology laboratories (CMLs) classified as university laboratories was 67% (18/27) compared to non-academic laboratories at 63% (31/49)
This study showed intra- and international differences in how Nordic CMLs organized their blood cultures (BCs) process
Summary
Modern healthcare systems depend on rapid and accurate diagnostics to optimize in-hospital care and reduce costs [1]. Diagnosis and appropriate treatment of severe infections such as bloodstream infections (BSIs) are crucial for survival [2e4]. Due to the global emergence of multidrug-resistant bacteria, it is important to provide susceptibility reports quickly to guide antibiotic treatment decisions [5,6]. Precision medicine, where decisions on appropriate antibiotic therapy are informed by microbiological reports, ensures that septic patients are offered equal and high standards of care [7e9]. Number of CMLs with 30 000 BCs analysed annually (% of responding CMLs) >60 000. Number of CML (%) 0e10 000 10 001e20 000 20 001e30 000 30 001e40 000
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