Collection, transport and storage procedures for blood culture specimens in adult patients: recommendations from a board of Italian experts

Plato, Francesca De; Fontana, Carla; Gherardi, Giovanni; Privitera, Gaetano Pierpaolo; Puro, Vincenzo; Rigoli, Roberto; Viaggi, Bruno; Viale, Pierluigi

doi:10.1515/cclm-2018-1146

Cited by 22 publications

(15 citation statements)

References 76 publications

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“…The number of cold or heat packs added to the package can change the thermal profile, and we identified an optimal condition for both blood and urine transportation packaging. The presented transportation protocol takes into consideration the clinical and technical factors that may have an impact on collection and transportation as detailed in other studies 9 , 10 .…”

Section: Discussionmentioning

confidence: 99%

Transportation protocols for accurate assessment of microbial burden classification using molecular methods

Kung

Chen

Tomasek

et al. 2021

Sci Rep

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Point-of-care testing is cost-effective, rapid, and could assist in avoiding hospital visits during a pandemic. However, they present some significant risks that current technologies cannot fully address. Skin flora contamination and insufficient specimen volume are two major limitations preventing self-collection microbiological testing outside of hospital settings. We are developing a hybrid testing procedure to bridge the laboratory test with patient-side specimen collection and transportation for molecular microbial classification of causative bacterial infection and early identification of microbial susceptibility profiles directly from whole blood or urine specimens collected patient-side by health care workers such as phlebotomists in nursing homes or family clinics. This feasibility study presents our initial development efforts, in which we tested various transportation conditions (tubes, temperature, duration) for direct-from-specimen viable pathogen detection to determine the ideal conditions that allowed for differentiation between contaminant and causative bacteria in urine specimens and optimal growth for low-concentration blood specimens after transportation. For direct-from-urine assays, the viable pathogen at the clinical cutoff of 105 CFU/mL was detected after transportation with molecular assays while contaminants (≤ 104 CFU/mL) were not. For direct-from-blood assays, contrived blood samples as low as 0.8 CFU/mL were reported positive after transportation without the need for blood culture.

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Section: Discussionmentioning

confidence: 99%

Transportation protocols for accurate assessment of microbial burden classification using molecular methods

Kung

Chen

Tomasek

et al. 2021

Sci Rep

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“…Studies have also shown that the amount of blood obtained for culturing has an influence on the number of false-negative and false-positive blood cultures. According to De Plato et al [ 22 ], volume of blood is the most important parameter when detecting microorganisms in the bloodstream. They have recommended 30–40 ml of blood obtained in total, distributed into two aerobic and two anaerobic bottles.…”

Section: Discussionmentioning

confidence: 99%

Microbiological findings in emergency department patients with sepsis identified by the Sepsis-3 criteria: a single-center prospective population-based cohort study

et al. 2021

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Background Studies comparing the microbiological profiles among sepsis patients identified with either Sequential Organ Failure Assessment (SOFA) score or systemic inflammatory response syndrome (SIRS) criteria are limited. The aim was to examine if there are differences in the microbiological findings among septic patients identified by Sepsis-3 criteria compared to patients identified by the previous sepsis criteria, SIRS, and without organ failure. A secondary purpose was to examine if we could identify microbiological characteristics with increased risk of 28-day mortality. Methods Prospective cohort study of all adult (≥ 18 years) patients admitted with sepsis to the Emergency Department of Slagelse Hospital, Denmark from 1st October 2017 to 31st March 2018. Information regarding microbiological findings was obtained via linkage between a sepsis database and the local microbiological laboratory data system. Data regarding 28-day mortality were obtained from the Danish Civil Registration System. We used logistic regression to estimate the association between specific microbiological characteristics and 28-day mortality. Results A total of 1616 patients were included; 466 (28.8%; 95% CI 26.6%-31.1%) met SOFA criteria, 398 (24.6%; 95% CI 22.5–26.8%) met SIRS criteria. A total of 127 patients (14.7%; 95% CI 12.4–17.2%) had at least one positive blood culture. SOFA patients had more often positive blood cultures compared to SIRS (13.9% vs. 9.5%; 95 CI on difference 0.1–8.7%). Likewise, Gram-positive bacteria (8.6% vs. 2.8%; 95 CI on difference 2.8–8.8%), infections of respiratory origin (64.8% vs. 57.3%; 95 CI on difference 1.0–14%), Streptococcus pneumoniae (3.2% vs. 1.0%; 95% CI on difference 0.3–4.1) and polymicrobial infections (2.6% vs. 0.3% 95 CI on difference 0.8–3.8%) were more common among SOFA patients. Polymicrobial infections (OR 3.70; 95% CI 1.02–13.40), Staphylococcus aureus (OR 6.30; 95% CI 1.33–29.80) and a pool of “other” microorganisms (OR 3.88; 95% CI 1.34–9.79) in blood cultures were independently associated with mortality. Conclusion Patients identified with sepsis by SOFA score were more often blood culture-positive. Gram-positive pathogens, pulmonary tract infections, Streptococcus pneumoniae, and polymicrobial infections were also more common among SOFA patients. Polymicrobial infection, Staphylococcus aureus, and a group of other organisms were independently associated with an increased risk of death.

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“…The gold standard for BSIs etiologic diagnosis is represented by the blood cultures followed by conventional pathogen identification and antimicrobial susceptibility testing. Unfortunately, even accelerating and tightly monitoring the pre-analytic and analytic phases [68], blood cultures turnaround-time is often long. In the last decades, the average reporting time of blood cultures results has been significantly shortened by the introduction of blood cultures automated monitoring systems and MALDI-TOF-based microbial identification [69,70].…”

Section: Bloodstream Infections At the Emergency Departmentmentioning

confidence: 99%

Diagnostic stewardship based on patient profiles: differential approaches in acute versus chronic infectious syndromes

Tiseo

Arena

Borrè³

et al. 2021

Expert Review of Anti-infective Therapy

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Collection, transport and storage procedures for blood culture specimens in adult patients: recommendations from a board of Italian experts

Cited by 22 publications

References 76 publications

Transportation protocols for accurate assessment of microbial burden classification using molecular methods

Transportation protocols for accurate assessment of microbial burden classification using molecular methods

Microbiological findings in emergency department patients with sepsis identified by the Sepsis-3 criteria: a single-center prospective population-based cohort study

Diagnostic stewardship based on patient profiles: differential approaches in acute versus chronic infectious syndromes

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