Palmieri Claudio, Bartolini Laura, Berlingeri Andrea, Camilloni Barbara, La Bella Gianfranco, Pascarella Michela, Selleri Marina, Valzano Felice, Vismara Chiara, Ambretti Simone, Fontana Carla, Rassu Mario, Rossolini Gian Maria, Arena Fabio, Mencacci Antonella
Becton Dickinson Italia S.p.A, Milan, Italy.
Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.
Eur J Clin Microbiol Infect Dis. 2025 Aug 18. doi: 10.1007/s10096-025-05238-x.
Bloodstream infections (BSIs) pose a significant health threat, requiring effective diagnostic processes to ensure appropriate treatment. Monitoring the quality of blood cultures (BCs) process (the cornerstone of BSIs etiological diagnosis) is critical. This study aimed to describe an automated tool, BD DREAM™ (Digital Remote Extraction Analysis & Monitoring), designed for monitoring key performance indicators (KPIs) in the BCs process.
A multicenter study was conducted across six Italian hospitals, analyzing 234,978 BC bottles, associated with 55,819 episodes. The system monitored KPIs related to mean blood volume per bottle, rates of solitary episodes, rate of BCs from central venous catheter (CVC) unpaired with concomitant BCs from peripheral vein, and contamination rates.
The findings highlighted significant variability in BC practices among centers and hospital services, with mean blood volume per bottle below recommended standards (6.45 mL vs. ≥ 8.0 mL), with 21.8% (range 3.2-62.9%) of episodes classified as solitary. The rate of BCs from CVC unpaired with concomitant BCs from peripheral vein was 14.9% (range 10.2-39.0%). Overall, contamination rates ranged from 4.2 to 4.7%, depending on the criteria adopted for definition. The setting with the more critical values was medical area.
The tool was useful for immediate visualization and identification of hospital services with critical performance. These results suggest that integrating BC digital monitoring tools into clinical microbiology workflows is possible. Further studies will be needed to demonstrate that the implementation of BD DREAM™ can lead to enhancement of diagnostic accuracy, optimization of resources allocation, and improvement of patient outcomes.
血流感染(BSIs)对健康构成重大威胁,需要有效的诊断流程以确保恰当治疗。监测血培养(BCs)流程的质量(BSIs病因诊断的基石)至关重要。本研究旨在描述一种自动化工具BD DREAM™(数字远程提取分析与监测),其设计用于监测BCs流程中的关键绩效指标(KPIs)。
在意大利的六家医院开展了一项多中心研究,分析了234,978瓶血培养瓶,涉及55,819次血培养事件。该系统监测与每瓶平均血量、孤立事件发生率、来自中心静脉导管(CVC)的血培养与外周静脉同时进行的血培养未配对的发生率以及污染率相关的关键绩效指标。
研究结果突出了各中心和医院科室在血培养操作方面存在显著差异,每瓶平均血量低于推荐标准(6.45 mL对≥8.0 mL),21.8%(范围3.2 - 62.9%)的事件被归类为孤立事件。来自CVC的血培养与外周静脉同时进行的血培养未配对的发生率为14.9%(范围10.2 - 39.0%)。总体而言,污染率根据定义采用的标准在4.2%至4.7%之间。关键值更高的科室是医疗科室。
该工具有助于即时可视化并识别绩效关键的医院科室。这些结果表明将血培养数字监测工具整合到临床微生物学工作流程中是可行的。还需要进一步研究来证明实施BD DREAM™可提高诊断准确性、优化资源分配并改善患者结局。