title: Reduced length of hospital stay through a point of care placed automated blood culture instrument.
abstract: Early appropriate antimicrobial treatment of patients with sepsis has a large impact on clinical outcome. To enable prompt and efficient processing of blood cultures, the inoculated vials should be placed into an automated continuously monitoring blood culture system immediately after sampling. We placed an extra BACTEC FX instrument at the emergency department of our hospital and validated the twice-daily re-entering of ongoing vials from this instrument into the BACTEC FX at the laboratory. We subsequently assessed the benefits of shortening the transport time between sampling and monitored incubation of blood culture vials by comparing the turnaround times of positive blood cultures from emergency department patients with a historical control group. Re-entering ongoing vials within 2 h raised no technical problems with the BACTEC FX and did not increase the risk of false-negative culture results. The decreased transport time resulted in significantly earlier available Gram stain results for a large proportion of patients in the intervention group and a significant shortening of the median total turnaround time to less than 48 h. The median length of hospital stay shortened by 1 day. Immediate entering of blood culture vials into a point of care placed BACTEC FX instrument and subsequent efficient processing enables earlier decision-making regarding antimicrobial treatment, preventing the development of antimicrobial resistance and reducing healthcare costs.
authors.affiliation: Laboratory of Clinical Microbiology and Infectious Diseases, Isala, Dr van Heesweg 2, 8025 AB, Zwolle, The Netherlands. m.j.bruins@isala.nl.
authors.forename: M J
authors.initials: MJ
authors.lastname: Bruins
authors.affiliation: Laboratory of Clinical Microbiology and Infectious Diseases, Isala, Dr van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Egbers
authors.affiliation: Laboratory of Clinical Microbiology and Infectious Diseases, Isala, Dr van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
authors.forename: T M
authors.initials: TM
authors.lastname: Israel
authors.affiliation: Department of Internal Medicine, Isala, Zwolle, The Netherlands.
authors.forename: S H A
authors.initials: SH
authors.lastname: Diepeveen
authors.affiliation: Laboratory of Clinical Microbiology and Infectious Diseases, Isala, Dr van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
authors.forename: M J H M
authors.initials: MJ
authors.lastname: Wolfhagen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000071997:Blood Culture / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D055502:Secondary Prevention; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy*