[Assessing the usefulness of a permanently opened clinical microbiology laboratory].
Since 2005, the clinical microbiology laboratory of the Angers teaching hospital has implemented after hours service requiring the overnight presence of a technician specialized in bacteriology. During that time, bacterial identifications and antibiotic susceptibility testing to antimicrobial agents can be performed for critical samples.


OBJECTIVE
The authors wanted to evaluate the impact of the after-hours service on the decrease of delay from sampling to results, and from sampling to the implementation of an appropriate antimicrobial therapy. A therapy could be initiated, changed for more efficient agents, or changed to narrower-spectrum agents (major benefits).


METHODS
A 4-month prospective study was made. All samples for which identification and/or susceptibility testing were performed during after-hours service (continued analyses) were included in the study. Delays observed were compared with theoretical delays estimated in the absence of the after-hours service.


RESULTS
A minimum 24 hour-decrease of the delay for results was observed for 97 % of the 430 samples included. Overall, a major benefit was obtained for more than 25 % of the analyses, representing a cumulated 111-day benefit in days of efficient treatments and a cumulated 27-day benefit in days of prescription of narrower-spectrum agents.


CONCLUSIONS
This organization, unique in French hospitals, is directly related to the improvement of antimicrobial treatments, like antibiotic practice guidelines or infection disease specialists. It was evaluated as a relevant strategy, potentially cost saving, with a significant impact on both the efficiency of treatments and microbial ecology.
Hitoto
H
H
Laboratoire de bactériologie, virologie - hygiène, CHU, 4, rue Larrey, 49933 Angers cedex 9, France.
Eveillard
M
M
Lemarié
C
C
Cottin
J
J
Joly-Guillou
M-L
ML
D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy; D001431:Bacteriological Techniques; D001432:Bacteriology / Q000458:organization & administration*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy; D005602:France; D006785:Hospitals, University / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007755:Laboratories, Hospital / Q000191:economics / Q000458:organization & administration*; D017056:Medical Laboratory Personnel; D008826:Microbial Sensitivity Tests; D009551:Night Care / Q000458:organization & administration; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D013048:Specimen Handling; D000078329:Workforce