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An assessment of the downstream implications of blood culture collection and transit

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Abstract  

The implications of the variables within the pre-analytical phase of blood culture processing are poorly understood. This study aims to explore the effect of transit times (TT) and culture volume, on time to microbiological diagnosis and patient outcomes. Blood cultures received between 1st March and 31st July 2020/21 were identified. TT, time in incubator (TII), and for positive samples, request to positivity times (RPT) were calculated. Demographic details were recorded for all samples, and culture volume, length of stay (LoS), and 30-day mortality for patients with positive samples. Statistical analysis examined how culture volume and TT effected culture positivity and outcome; in the context of the 4-h national TT target. Totally, 14,375 blood culture bottles were received from 7367 patients; 988 (13.4%) were positive for organisms. There was no significant difference between TT of negative and positive samples. The RPT was significantly lower for samples with TT < 4 h (p < 0.001). Culture bottle volume did not affect RPT (p = 0.482) or TII (p = 0.367). A prolonged TT was associated with a longer length-of-stay in those with a bacteraemia with a significant organism (p = 0.001). We found shorter blood culture transportation time was associated with a significantly faster time of positive culture reporting, while optimal blood culture volume did not make a significant impact. Delays in reporting for significant organisms correspond to a prolonged LoS. Laboratory centralisation makes achieving the 4-h target a logistical challenge; however, this data suggests such targets have significant microbiological and clinical impacts.

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Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Medical Microbiology, Glasgow Royal Infirmary, Glasgow, UK

    Peter J. B. Davies, Timothy P. W. Jones & Mairi Macleod

  2. Department of Infectious Diseases, John Radcliffe Hospital, Oxford, UK

    Timothy P. W. Jones

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  1. Peter J. B. Davies
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  2. Timothy P. W. Jones
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  3. Mairi Macleod
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Peter Davies and Timothy Jones. The first draft of the manuscript was written by Peter Davies and Timothy Jones, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Peter J. B. Davies.

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This is a retrospective observational study, and ethical approval was not required. The Caldicott Guardian consented to data access for the study.

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As this was a retrospective observational study, consent was not possible.

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The authors declare no competing interests.

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Davies, P.J.B., Jones, T.P.W. & Macleod, M. An assessment of the downstream implications of blood culture collection and transit. Eur J Clin Microbiol Infect Dis 42, 835–842 (2023). https://doi.org/10.1007/s10096-023-04610-z

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  • DOI: https://doi.org/10.1007/s10096-023-04610-z

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