Blood culture pre-analytical KPIs – The next challenge in microbiology?

The blood culture pathway is often thought of as a relatively straightforward one; sample to laboratory and result to clinician but, in reality, is a complex network of multidisciplinary stakeholders that is dependent on timely interventions and limited by availability of services and diagnostic tools, says Kate Donnachie.

Blood cultures remain the standard for the investigation of blood stream infections (BSIs) and are recommended as one of the earliest actions for patients who present with signs of sepsis or septic shock.1,2 The results gathered from blood culture investigations allow for the identification and appropriate therapy of the causative agent of these infections. Collection of samples ahead of empiric antimicrobial administration is advised and the results can lead to more targeted therapy. Therefore, prompt and accurate investigation of blood cultures positively impacts antimicrobial stewardship and reduces unnecessary exposure of patients to inappropriate drugs and their associated side effects. Ideally this process should operate 24/7 with all services; clinical, support and laboratory operating at an appropriate capacity to ensure no differentiation between a sample taken during ‘office hours’ and one taken at 3am. The reality of the situation is, unfortunately only around 42% of European hospitals are loading blood cultures on a 24/7 basis with only 13% processing positive blood cultures around the clock.3

The pre-analytical steps, laboratory processing and clinical action based on results are all instrumental in ensuring the optimisation of the pathway, and any delay in results can lead to inappropriate therapy, prolonged patient stay, increased risk of antimicrobial resistance, and ultimately negatively impact patient care in general.4,5

Guidelines and recommendations

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