title: Survey of physicians' perspectives and knowledge about diagnostic tests for bloodstream infections.
abstract: BACKGROUND
  Physicians rely on blood culture to diagnose bloodstream infections (BSI) despite its limitations. As new technologies emerge for rapid BSI diagnosis, optimization of their application to patient care requires an understanding of clinicians' perspectives on BSI diagnosis and how a rapid test would influence medical decisions.
  
  
  METHODS
  We administered a 26-question survey to practitioners in infectious diseases/microbiology, critical care, internal medicine, and hematology/oncology services in USA and Germany about current standards in diagnosing and treating BSI and a hypothetical rapid BSI test.
  
  
  RESULTS
  Responses from 242 providers had roughly equal representation across specialties. For suspected BSI patients, 78% of practitioners would administer empiric broad spectrum antibiotics although they estimated, on average, that 31% of patients received incorrect antibiotics while awaiting blood culture results. The ability of blood culture to rule in or rule out infection was very/extremely acceptable in 67% and 36%, respectively. Given rapid test results, 60-87% of practitioners would narrow the spectrum of antimicrobial therapy depending on the microorganism detected, with significantly higher percentages when resistance determinants were also tested. Over half of respondents felt a rapid test would be very/extremely influential on clinical practice.
  
  
  CONCLUSIONS
  Limitations of blood culture were perceived as a barrier to patient care. A rapid test to diagnose BSI would impact clinical practice, but the extent of impact may be limited by prevailing attitudes and practices. Opportunities exist for interventions to influence practitioners' behaviors in BSI management particularly with emergence of newer diagnostic tests.
authors: Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States of America.
authors: Rosemary C
authors: RC
authors: She
authors: Department of Medicine, Morsani School of Medicine, University of South Florida, Tampa, Florida, United States of America.
authors: Sally
authors: S
authors: Alrabaa
authors: Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States of America.
authors: Seung Heon
authors: SH
authors: Lee
authors: nanoMR Inc., Albuquerque, New Mexico, United States of America.
authors: Meghan
authors: M
authors: Norvell
authors: Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, United States of America.
authors: Andrew
authors: A
authors: Wilson
authors: Department of Medicine, Morsani School of Medicine, University of South Florida, Tampa, Florida, United States of America; HealthSpring Global Inc., Bradenton, Florida, United States of America.
authors: Cathy A
authors: CA
authors: Petti
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002983:Clinical Competence; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D010818:Practice Patterns, Physicians'; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D059039:Standard of Care; D011795:Surveys and Questionnaires
chemical_list: D000890:Anti-Infective Agents