Blood culture quality and turnaround time of clinical microbiology laboratories in Chinese Teaching Hospitals: A multicenter study

作者：Liu, Wanting; Liao, Kang; Wu, Jinsong; Liu, Suling; Zheng, Xin; Wen, Weihong; Fu, Liang; Fan, Xiaoyi; Yang, Xiao; Hu, Xiumei; Jiang, Yueting; Wu, Kuihai; Guo, Zhusheng; Li, Yang; Liu, Weiyang; Cai, Mufa; Guo, Zhaowang; Guo, Xuguang; Lu, Jinghui; Chen, Enzhong; Zhou, Hongwei^*; Chen, Dingqiang^*

来源：Journal of Clinical Laboratory Analysis, 2024, 38(1-2): e25008.

DOI：10.1002/jcla.25008

• blood culture
• clinical microbiology laboratory
• key performance indicators
• laboratory workflow
• turnaround time

PurposeBlood culture (BC) remains the gold standard for the diagnosis of bloodstream infections. Improving the quality of clinical BC samples, optimizing BC performance, and accelerating antimicrobial susceptibility test (AST) results are essential for the early detection of bloodstream infections and specific treatments.MethodsWe conducted a retrospective multicenter study using 450,845 BC specimens from clinical laboratories obtained from 19 teaching hospitals between 1 January 2021 and 31 December 2021. We evaluated key performance indicators (KPIs), turnaround times (TATs), and frequency distributions of processing in BC specimens. We also evaluated the AST results of clinically significant isolates for four different laboratory workflow styles.ResultsAcross the 10 common bacterial isolates (n = 16,865) and yeast isolates (n = 1011), the overall median (interquartile range) TATs of AST results were 2.67 (2.05-3.31) and 3.73 (2.98-4.64) days, respectively. The specimen collections mainly occurred between 06:00 and 24:00, and specimen reception and loadings mainly between 08:00 and 24:00. Based on the laboratory workflows of the BCs, 16 of the 19 hospitals were divided into four groups. Time to results (TTRs) from specimen collection to the AST reports were 2.35 (1.95-3.06), 2.61 (1.98-3.32), 2.99 (2.60-3.87), and 3.25 (2.80-3.98) days for groups I, II, III, and IV, respectively.ConclusionThis study shows the related BC KPIs and workflows in different Chinese hospitals, suggesting that laboratory workflow optimization can play important roles in shortening time to AST reports and initiation of appropriate timely treatment. @@@ The median turnaround times from specimen collection to the AST reports were 2.35, 2.61, 2.99, and 3.25 days for laboratory workflow groups I, II, III, and IV, respectively. There are significant differences in the quality and process of blood culture among different teaching hospitals in Guangdong Province, China. To improve the efficiency and accuracy of blood culture testing, it is recommended that further optimization measures be considered for the numbers and types of blood culture bottles used, as well as the laboratory workflows in these hospitals.image

• 单位
  广东省人民医院; 佛山市第一人民医院; 中山大学; 广州医学院; 1; 南方医科大学; 广东药学院; 5; 6; 广东医学院