Affordable Access

Access to the full text

Laboratory automation reduces time to report of positive blood cultures and improves management of patients with bloodstream infection

Authors
  • De Socio, Giuseppe Vittorio
  • Di Donato, Francesco
  • Paggi, Riccardo
  • Gabrielli, Chiara
  • Belati, Alessandra
  • Rizza, Giuseppe
  • Savoia, Martina
  • Repetto, Antonella
  • Cenci, Elio
  • Mencacci, Antonella
Type
Published Article
Journal
European Journal of Clinical Microbiology & Infectious Diseases
Publisher
Springer-Verlag
Publication Date
Sep 14, 2018
Volume
37
Issue
12
Pages
2313–2322
Identifiers
DOI: 10.1007/s10096-018-3377-5
Source
Springer Nature
Keywords
License
Yellow

Abstract

The impact on time to results (TTR) and clinical decisions was evaluated for mono-microbial positive blood cultures (BC) processed using the BD Kiestra Work Cell Automation (WCA) system. Positive BC were processed by the WCA system by full-automatic subculture on solid media and digital imaging after 8 h of incubation (8-h method) followed by identification (ID) and antimicrobial susceptibility testing (AST). To evaluate the accuracy of the 8-h method, ID and AST from 8-h and overnight incubated colonies were compared for the same organisms. To evaluate its clinical impact, results from 102 BC processed by the 8-h method (cases) were compared with those from 100 BC processed by overnight incubation method (controls) in a comparable period. Identification after 8-h and overnight incubation gave concordant results in 101/102 (99.0%) isolates. Among a total of 1379 microorganism-antimicrobial combinations, categorical agreement was 99.4% (1371/1379); no very major error, 7 major errors, and one minor error were observed. TTR in cases (32.8 h ± 8.3 h) was significantly (p < 0.001) shorter than in controls (55.4 h ± 13.3 h). A significant reduction was observed for duration of empirical therapy (cases 54.8 h ± 23.3 h vs controls 86.9 h ± 34.1 h, p < 0.001) and 30-day crude mortality rate (cases 16.7% vs controls 29.0%, p < 0.037). Automation and 8-h digital reading of plates from positive BC, followed by ID and AST, greatly reduce TTR and shorten the duration of antimicrobial empiric therapy, possibly improving outcome in patients with mono-microbial bloodstream infections.

Report this publication

Statistics

Seen <100 times