Department of Clinical Laboratory, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China.
Department of Critical Care Medicine, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China.
Int J Antimicrob Agents. 2024 Jun;63(6):107176. doi: 10.1016/j.ijantimicag.2024.107176. Epub 2024 Apr 18.
Optimising blood culture processing is important to ensure that bloodstream infections are accurately diagnosed while minimising adverse events caused by antibiotic abuse. This study aimed to evaluate the impact of optimised blood culture processes on antibiotic use, clinical outcomes and economics in intensive care unit (ICU) patients with positive blood cultures.
From March 2020 to October 2021, this microbiology laboratory implemented a series of improvement measures, including the clinical utility of Fastidious Antimicrobial Neutralization (FAN® PLUS) bottles for the BacT/Alert Virtuo blood culture system, optimisation of bottle reception, graded reports and an upgraded laboratory information system. A total of 122 ICU patients were included in the pre-optimisation group from March 2019 to February 2020, while 179 ICU patients were included in the post-optimisation group from November 2021 to October 2022.
Compared with the pre-optimisation group, the average reporting time of identification and antimicrobial sensitivity was reduced by 16.72 hours in the optimised group. The time from admission to targeted antibiotic therapy within 24 hours after receiving both the Gram stain report and the final report were both significantly less in the post-optimisation group compared with the pre-optimisation group. The average hospitalisation time was reduced by 6.49 days, the average antimicrobial drug cost lowered by $1720.85 and the average hospitalisation cost by $9514.17 in the post-optimisation group.
Optimising blood culture processing was associated with a significantly increased positive detection rate, a remarkable reduction in the length of hospital stay and in hospital costs for ICU patients with bloodstream infections.
优化血培养处理对于确保准确诊断血流感染并最大限度减少抗生素滥用引起的不良事件非常重要。本研究旨在评估优化血培养流程对重症监护病房（ICU）阳性血培养患者抗生素使用、临床结局和经济学的影响。
从 2020 年 3 月至 2021 年 10 月，本微生物实验室实施了一系列改进措施，包括 Fastidious Antimicrobial Neutralization（FAN® PLUS）瓶在 BacT/Alert Virtuo 血培养系统中的临床应用、瓶接收优化、分级报告和升级实验室信息系统。共有 122 名 ICU 患者纳入 2019 年 3 月至 2020 年 2 月的预优化组，179 名 ICU 患者纳入 2021 年 11 月至 2022 年 10 月的优化组。
与预优化组相比，优化组鉴定和抗菌药物敏感性的平均报告时间缩短了 16.72 小时。在优化组中，革兰氏染色报告和最终报告均收到后 24 小时内接受靶向抗生素治疗的入院至开始时间均显著缩短。优化组的平均住院时间缩短了 6.49 天，抗菌药物费用降低了 1720.85 美元，住院费用降低了 9514.17 美元。
优化血培养处理与 ICU 血流感染患者阳性检出率显著提高、住院时间和住院费用显著降低有关。
