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Journal of Clinical Microbiology, November 2009, p. 3520-3523, Vol. 47, No. 11
0095-1137/09/$08.00+0     doi:10.1128/JCM.01092-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Immediate Incubation of Blood Cultures Outside Routine Laboratory Hours of Operation Accelerates Antibiotic Switching{triangledown}

J. J. Kerremans,* A. K. van der Bij, W. Goessens, H. A. Verbrugh, and M. C. Vos

Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands

Received 4 June 2009/ Returned for modification 8 July 2009/ Accepted 20 August 2009

The aim of this prospective randomized controlled clinical trial was to assess the impact of immediate incubation of blood cultures delivered to the laboratory outside its hours of operation on turnaround times, antibiotic prescription practices, and patient outcomes. A continuously monitoring blood culture incubator was placed outside the laboratory, which was switched on (intervention arm) and off (control arm) in a randomized manner. Included were new bacteremia episodes of patients older than 18 years. During the 30-week study period, the first positive blood culture specimen of an episode had to be brought to the laboratory outside its hours of operation. The median time from specimen collection until growth detection was reduced by 10.1 h in the intervention arm (P < 0.001). For 46 of 66 (70%) episodes in the intervention arm and for 51 of 85 (60%) episodes in the control arm, the antibiotic regimen was changed (not significant). The median time until the first change in the antibiotic regimen was 42.8 h in the intervention arm and 64.0 h in the control arm (P, 0.024). There was no difference in length of stay or hospital mortality. Immediate incubation of blood cultures outside laboratory hours reduces turnaround times and accelerates antibiotic switching.

* Corresponding author. Mailing address: Erasmus University Medical Centre Rotterdam, Department of Medical Microbiology and Infectious Diseases, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Phone: 31-10-7033510. Fax: 31-10-7033875. E-mail: jjkerremans{at}diaconessenhuis.nl

{triangledown} Published ahead of print on 26 August 2009.

Journal of Clinical Microbiology, November 2009, p. 3520-3523, Vol. 47, No. 11
0095-1137/09/$08.00+0     doi:10.1128/JCM.01092-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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