title: The impact of performing bacterial identification and antimicrobial susceptibility testing on bronchoalveolar fluid cultures 24 h a day in a microbiology laboratory.
abstract: We previously demonstrated the positive impact of performing bacterial identification and antimicrobial susceptibility testing (AST) after day hours (night service [NS]) for certain clinical samples on the treatment of infected patients. Our objective was to evaluate the impact of including positive bronchoalveolar lavage (BAL) cultures in our NS. Two major positive consequences were recorded: initiation of earlier appropriate treatment and earlier change to a reduced-spectrum but still effective regimen. Reductions in delay were defined as the differences between the hours actually spent and hours estimated as though laboratory tests had been performed in the absence of NS. Fifty BALs were included. The NS led to the implementation of earlier appropriate therapy in 10 cases (20%), to earlier de-escalation in 15 cases (30%), and to earlier appropriate therapy and de-escalation in 4 cases (8%). In conclusion, performing bacterial identification and AST for positive BAL after laboratory opening hours could be relevant.
authors.affiliation: CHU d'Angers, Laboratoire de Bactériologie, F-49000 Angers, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Pailhoriès
authors.affiliation: CHU d'Angers, Laboratoire de Bactériologie, F-49000 Angers, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Lemarié
authors.affiliation: CHU d'Angers, Service de Réanimation médicale, F-49000 Angers, France.
authors.forename: Achille
authors.initials: A
authors.lastname: Kouatchet
authors.affiliation: CHU d'Angers, Service de Réanimation Chirurgicale A, F-49000 Angers, France.
authors.forename: Sigismond
authors.initials: S
authors.lastname: Lasocki
authors.affiliation: CHU d'Angers, Service de Réanimation Chirurgicale B, F-49000 Angers, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Sargentini
authors.affiliation: CHU d'Angers, Laboratoire de Bactériologie, F-49000 Angers, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Kempf
authors.affiliation: CHU d'Angers, Laboratoire de Bactériologie, F-49000 Angers, France.
authors.forename: Noémie
authors.initials: N
authors.lastname: Coron
authors.affiliation: CHU d'Angers, Laboratoire de Bactériologie, F-49000 Angers, France.
authors.forename: Chetaou
authors.initials: C
authors.lastname: Mahaza
authors.affiliation: CHU d'Angers, Laboratoire de Bactériologie, F-49000 Angers, France.
authors.forename: Marie-laure
authors.initials: ML
authors.lastname: Joly-Guillou
authors.affiliation: CHU d'Angers, Laboratoire de Bactériologie, F-49000 Angers, France. Electronic address: MaEveillard@chu-angers.fr.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Eveillard
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D001431:Bacteriological Techniques / Q000379:methods*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D006801:Humans; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: De-escalation; Earlier appropriate treatment; Intensive care units; Night service; Respiratory samples