Microbiological diagnostics of bloodstream infections in Europe - An ESGBIES survey.
Clin Microbiol Infect. 2019 Apr 10;:
Authors: Idelevich EA, Seifert H, Sundqvist M, Scudeller L, Amit S, Balode A, Bilozor A, Drevinek P, Tufan ZK, Koraqi A, Lamy B, Mareković I, Miciuleviciene J, Premru MM, Pascual A, Pournaras S, Saegeman V, Schønheyder HC, Schrenzel J, Strateva T, Tilley R, Wiersinga WJ, Zabicka D, Carmeli Y, Becker K, ESCMID Study Group for Bloodstream Infections, Endocarditis and Sepsis (ESGBIES)
OBJECTIVES: High-quality diagnosis of bloodstream infections (BSIs) is important for successful patient management. As knowledge on current practices of microbiological BSI diagnostics is limited, this project aimed to assess its current state in European microbiological laboratories.
METHODS: We performed an online questionnaire-based cross-sectional survey comprising 34 questions on practices of microbiological BSI diagnostics. The ESCMID Study Group for Bloodstream Infections, Endocarditis and Sepsis (ESGBIES) was the primary platform to engage national coordinators who recruited laboratories within their countries.
RESULTS: Responses were received from 209 laboratories in 25 European countries. While 32.5% (68/209) of laboratories only used the classical processing of positive blood cultures (BCs), two-thirds applied rapid technologies. Of laboratories that provided data for respective question, 42.2% (78/185) were able to start incubating blood cultures in automated BC incubators around-the-clock, and only 13% (25/192) had established a 24-hour service to start immediate processing of positive BCs. Only 4.7% (9/190) of laboratories validated and transmitted the results of identification and antimicrobial susceptibility testing (AST) of BC pathogens to clinicians 24 hours/day. MALDI-TOF MS from shortly incubated sub-cultures on solid media was the most commonly used approach to rapid pathogen identification from positive BCs, and direct disk diffusion was the most common rapid AST method from positive BCs.
CONCLUSIONS: Laboratories have started to implement novel technologies for rapid identification and AST for positive BCs. However, progress is severely compromised by limited operating hours such that current practice of BC diagnostics in Europe complies only partly with the requirements for optimal BSI management.
PMID: 30980927 [PubMed - as supplied by publisher]