Clinical impact of reducing routine blood culture incubation time from 7 to 5 days

Pathology ◽  
2014 ◽  
Vol 46 (7) ◽  
pp. 636-639 ◽  
Author(s):  
Michael J. Marginson ◽  
Kathryn L. Daveson ◽  
Karina J. Kennedy
Keyword(s):  
Blood Culture ◽  
Incubation Time ◽  
Clinical Impact ◽  
Routine Blood

scholarly journals 2559. Incidence and Clinical Impact of Discordant Genotypic and Phenotypic Categorization of Methicillin Susceptibility in Staphylococcus aureus Bacteremia

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S70-S70
Author(s):  
Jessica Gulliver ◽  
Brittney Jung-Hynes ◽  
Derrick Chen
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Rapid Identification ◽  
Clinical Impact ◽  
Staphylococcus Aureus Bacteremia ◽  
Oxacillin Resistance ◽  
Initial Hospitalization

Abstract Background Methicillin-susceptible/methicillin-resistant Staphylococcus aureus (MSSA/MRSA) can be directly identified from positive blood culture bottles using molecular methods. This provides faster results than traditional phenotypic testing, but discrepancies between the two are occasionally found. We sought to determine the incidence and clinical impact of such discrepancies. Methods Positive blood culture bottles are routinely tested in the hospital clinical laboratory for mecA via Xpert MRSA/SA BC (PCR), and antimicrobial susceptibility testing (AST) via MicroScan PC33 is performed on recovered S. aureus isolates; discrepancies between PCR and AST are resolved by repeat and supplemental (Kirby-Bauer) testing. A retrospective review of medical and laboratory data from January 2015 to December 2017 was performed on all patients that had discordant PCR and AST results. Results Approximately 1,200 PCR assays were performed from January 2015 to December 2017, and there were 5 (0.4%) cases with discordant AST Results. Four cases were classified as MSSA by PCR but MRSA by AST, and 1 case was classified as MRSA by PCR but MSSA by AST. For the former group, antimicrobial therapy was changed in 2 patients to cover MRSA and 1 patient was readmitted, while the remaining 2 patients were already being treated for MRSA; for the latter case, this patient was treated for MRSA during the initial hospitalization, but was readmitted with disseminated MSSA and subsequently deceased. Based on genetic targets identified by PCR and cefoxitin and oxacillin AST, discrepancies were likely due to borderline oxacillin resistance (BORSA) (n = 1), presence of an SCCmec variant not detected by PCR (n = 1), or undetermined (n = 3). Conclusion Rapid identification of MRSA bacteremia via PCR provides actionable information to direct empiric treatment. While highly accurate, PCR results are infrequently not corroborated by AST. This rare possibility should be considered when modifying therapy based on initial PCR results, and there should be close communication between the clinical team and laboratory for these challenging cases. Disclosures All authors: No reported disclosures.

scholarly journals Effect of Antifungal Therapy Timing on Mortality in Cancer Patients with Candidemia

2009 ◽  
Vol 54 (1) ◽  
pp. 184-190 ◽  
Author(s):  
Ying Taur ◽  
Nina Cohen ◽  
Sarah Dubnow ◽  
Alla Paskovaty ◽  
Susan K. Seo
Keyword(s):  
Blood Culture ◽  
Hospital Mortality ◽  
Cancer Patients ◽  
Incubation Period ◽  
Antifungal Therapy ◽  
Incubation Time ◽  
Culture Collection ◽  
Diagnostic Methods ◽  
Apache Iii ◽  
Blood Culture Positivity

ABSTRACT Prior studies have shown that delays in treatment are associated with increased mortality in patients with candidemia. The purpose of this study was to measure three separate time periods comprising the diagnosis and treatment of candidemia and to determine which one(s) is associated with hospital mortality. Patients with blood cultures positive for Candida spp. were identified. Subjects were excluded if no antifungal therapy was given or if there was preexisting antifungal therapy. Collected data included the time from blood culture collection to positivity (incubation period), the time from blood culture positivity to provider notification (provider notification period), and the time from provider notification to the first dose of antifungal given (antifungal initiation period). These times were assessed as predictors of inpatient mortality. A repeat analysis was done with adjustments for age, sex, race, underlying cancer, catheter removal, APACHE III score, acute renal failure, neutropenia, and non-Candida albicans species. A total of 106 episodes of candidemia were analyzed. The median incubation time was 32.1 h and was associated with mortality (univariate hazard ratio per hour, 1.025; P = 0.001). The median provider notification and antifungal initiation periods were 0.3 and 7.5 h, respectively, and were not associated with mortality. Adjusted analysis yielded similar results. For cancer patients with candidemia, the incubation period accounts for a significant amount of time, compared with the provider notification and antifungal initiation times, and is associated with in-hospital mortality. Strategies to shorten the incubation time, such as utilizing rapid molecularly based diagnostic methods, may help reduce in-hospital mortality.

Reassessment of the routine anaerobic culture and incubation time in the BacT/Alert FAN blood culture bottles

1999 ◽  
Vol 35 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Nancy Cornish ◽  
Barbara A Kirkley ◽  
Kirk A Easley ◽  
John A Washington
Keyword(s):  
Blood Culture ◽  
Incubation Time ◽  
Anaerobic Culture

scholarly journals The Clinical Impact of Metagenomic Next-Generation Sequencing (mNGS) Test in Hospitalized Patients with Suspected Sepsis: A Multicenter Prospective Study.

2021 ◽  
Author(s):  
Yi-Hui Zuo ◽  
Yi-xing Wu ◽  
Yan Chen ◽  
Yu-ping Li ◽  
Zhen-ju Song ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Characteristics ◽  
Early Stage ◽  
Clinical Impact ◽  
Antibiotic Regimen ◽  
Suspected Sepsis ◽  
Diagnostic Efficacy ◽  
Antibiotics Use ◽  
Regimen Modification ◽  
Generation Sequencing

Abstract Background:Next Generation Sequencing (NGS) is a newly developed technology and able to detect pathogens rapidly, which may have great importance in early diagnosis and clinical management of infectious diseases. Our study aimed to assess the diagnostic performance and clinical impact of metagenomic NGS (mNGS) in hospitalized patients with suspected sepsis and analyze the suitable population for mNGS test besides culture.Methods:A multi-center, prospective cohort study was performed. We enrolled eligible patients with hospitalized infection, collected demographic and clinical characteristics, and record the 30-day survival. Blood samples were collected on the day of enrollment to perform blood culture and mNGS test. Diagnostic efficacy of mNGS test and blood culture were calculated, and clinical impact of antibiotic regimen modification based on pathogenic test were also analyzed with SPSS22.0 (SPSS Inc, Chicago, IL).Results:We collected demographic and clinical characteristics of patients, and record the 30-day survival. Blood samples were collected on the day of enrollment to perform blood culture and mNGS test. Diagnostic efficacy of mNGS test and blood culture were calculated, and clinical impact of antibiotic regimen modification based on pathogenic test were also analyzed. A total of 277 patients were enrolled and 162 were diagnosed with sepsis. Among patients with 30-day follow-up data, the mortality was 44.8% (121/270). The mNGS test exhibited shorter turn-out time [27.0(26.0, 29.0) vs 96.0(72.0, 140.3) hours, P < 0.001] and higher sensitivity (90.54% vs 36.00%, P < 0.001) than blood culture, especially for fungal infections. The mNGS test showed better performance for patients with mild symptoms, prior antibiotics use, and early stage of infection than blood culture. Higher reads of pathogens detected by mNGS was related to 30-day mortality (P=0.002). The mNGS test was capable of guiding antibiotic regimen modification and ameliorating prognosis. Negative mNGS results helped with antibiotic de-escalation safely.Conclusions mNGS technology may be helpful for patients with possible blood-stream infections, especially in fungal infection and for patients with mild symptoms, prior antibiotics use and early stage of infection. Its role in antibiotic stewardship and ameliorating prognosis warrants further study.Trial registrationThe study was registered on the Chinese Clinical Trial Registry (Number: ChiCTR1800019187) on 01/24/2019 (Retrospectively registered).

Clinical impact of rapid identification and susceptibility testing of bacterial blood culture isolates.

1989 ◽  
Vol 27 (6) ◽  
pp. 1342-1345 ◽  
Author(s):  
G M Trenholme ◽  
R L Kaplan ◽  
P H Karakusis ◽  
T Stine ◽  
J Fuhrer ◽  
...  
Keyword(s):  
Blood Culture ◽  
Susceptibility Testing ◽  
Rapid Identification ◽  
Clinical Impact

scholarly journals Evaluation of Optimal Blood Culture Incubation Time to Maximize Clinically Relevant Results from a Contemporary Blood Culture Instrument and Media System

2020 ◽  
Author(s):  
Eric M. Ransom ◽  
Zahra Alipour ◽  
Meghan A. Wallace ◽  
Carey-Ann D. Burnham
Keyword(s):  
Blood Culture ◽  
Incubation Time ◽  
Negative Impact ◽  
Culture Media ◽  
Detection System ◽  
Blood Cultures ◽  
Standard Interval ◽  
Media System ◽  
Blood Culture Positivity ◽  
Optimal Incubation

Timely diagnosis of microorganisms in blood cultures is necessary to optimize therapy. Although blood culture media and systems have evolved for decades, the standard interval for incubation prior to discard as negative has remained five days. Here, we evaluated the optimal incubation time for the BACT/ALERT VIRTUO blood culture detection system (bioMérieux) using FA Plus (aerobic) and FN Plus (anaerobic) resin culture bottles in routine clinical use. Following IRB approval, a retrospective review evaluated the outcomes of 158,710 bottles collected between November 2018 and October 2019. The number of positive blood bottles was 13,592 (8.6%); 99% of positive aerobic and anaerobic bottles flagged positive by 91.5 h and 108 h, respectively. The mean (median) time-to-positivity for Staphylococcus aureus was 18.4 h (15.6 h), Escherichia coli 12.3 h (9.5 h), Pseudomonas aeruginosa 22.2 h (15.9 h), and Candida spp. 48.9 h (42.9 h). Only 175 bottles (0.1% of all bottles) flagged positive after four days of incubation; 89 (51%) of these bottles grew Cutibacterium (Propionibacterium) species. Chart review of blood cultures positive after four days (96 h) rarely had clinical impact, and sometimes had a negative impact on patientcare. Finally, a seeded study of the HACEK group, historically associated with delayed blood culture positivity, demonstrated no benefit to extended incubation beyond four days. Collectively, these findings demonstrated that a four-day incubation time was sufficient for the VIRTUO system and media. Implementation of the four-day incubation time could enhance clinically relevant results by reducing recovery of contaminants and finalizing blood cultures one day earlier.

Sign in / Sign up

Export Citation Format

Share Document