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Microbiological diagnostics of bloodstream infections in Europe-an ESGBIES survey
Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Laboratory Medicine, Clinical Microbiology.
Clinical Epidemiology Unit, Scientific Direction, Fondazione IRCCS, Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy.
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2019 (English)In: Clinical Microbiology and Infection, ISSN 1198-743X, E-ISSN 1469-0691, Vol. 25, no 11, p. 1399-1407Article in journal (Refereed) Published
Abstract [en]

Objectives: High-quality diagnosis of bloodstream infections (BSI) 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. Although 32.5% (68/209) of laboratories only used the classical processing of positive blood cultures (BC), two-thirds applied rapid technologies. Of laboratories that provided data, 42.2% (78/185) were able to start incubating BC in automated BC incubators around-the-clock, and only 13% (25/192) had established a 24-h service to start immediate processing of positive BC. 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 h/day. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry from briefly incubated sub-cultures on solid media was the most commonly used approach to rapid pathogen identification from positive BC, and direct disc diffusion was the most common rapid AST method from positive BC.

Conclusions: Laboratories have started to implement novel technologies for rapid identification and AST for positive BC. 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.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 25, no 11, p. 1399-1407
Keywords [en]
Antimicrobial susceptibility testing, Blood culture, Bloodstream infection, Identification, Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, Microbiological diagnostics, Molecular methods, Preanalytics, Rapid diagnostics, Transport
National Category
Infectious Medicine Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-77805DOI: 10.1016/j.cmi.2019.03.024ISI: 000492683600017PubMedID: 30980927Scopus ID: 2-s2.0-85064927303OAI: oai:DiVA.org:oru-77805DiVA, id: diva2:1369658
Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2020-12-01Bibliographically approved

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