Alexander Mobbs and colleagues examine the effect that pre-analytical delay may have on the subsequent processing of blood cultures, and compare results obtained from two hospitals – one with an on-site laboratory, the other remote from the pathology service.
Bloodstream infections (BSI) are an important cause of serious morbidity and mortality. Early and rapid administration of the correct empirical antibiotics has been shown to increase survival rates. The gold standard for diagnosis remains blood culture; therefore, the clinical microbiology laboratory can play a significant role in the management of patients with suspected sepsis.
In order for patients to receive the best possible outcomes, it is vital that the turnaround time (TAT) is reduced at each stage of the process. Fully automated, continuous blood culture systems have led to a decrease in the time to detection and identification of pathogens. Owing to the clinical significance of blood culture, there is an aspirational target of four hours from collection to the culture bottles being loaded onto the monitoring system. To achieve this, there is a range of pre-analytical factors that can be improved, such as i) transportation arrangements, ii) out-of-hours service provision, and iii) the availability of a continuous blood culture monitoring system.
The Oxford University Hospitals NHS Foundation Trust microbiology laboratory is situated at the John Radcliffe Hospital in Oxford, 29 miles away from the Horton General Hospital in Banbury. Current transportation arrangements can be seen in Table 1. It was suggested that there could be a significant delay between the samples sent from on-site locations in comparison to those sent from the Horton General Hospital.
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