Objectives

Accurate and rapid microbiological diagnostics are crucial to tailor treatment and improve outcomes in patients with severe infections. This study aimed to assess blood culture diagnostics in the Nordic countries and to compare them with those of a previous survey conducted in Sweden in 2013.

Methods

An online questionnaire was designed and distributed to the Nordic clinical microbiology laboratories (CMLs) (n = 76) in January 2018.

Results

The response rate was 64% (49/76). Around-the-clock incubation of blood cultures (BCs) was supported in 82% of the CMLs (40/49), although in six of these access to the incubators around the clock was not given to all of the cabinets in the catchment area, and 41% of the sites (20/49) did not assist with satellite incubators. Almost half (49%, 24/49) of the CMLs offered opening hours for ≥10 h during weekdays, more commonly in CMLs with an annual output ≥30 000 BCs. Still, positive BCs were left unprocessed for 60–70% of the day due to restrictive opening hours. Treatment advice was given by 23% of CMLs (11/48) in ≥75% of the phone contacts. Rapid analyses (species identification and susceptibility testing with short incubation), performed on aliquots from positive cultures, were implemented in 18% of CMLs (9/49). Compared to 2013, species identification from subcultured colonies (<6 h) had become more common.

Conclusions

CMLs have taken action to improve aspects of BC diagnostics, implementing satellite incubators, rapid species identification and susceptibility testing. However, the limited opening hours and availability of clinical microbiologists are confining the advantages of these changes.

中文翻译：

---

血培养诊断：临床微生物实验室实践的北欧多中心调查比较

目标

准确和快速的微生物诊断对于定制治疗和改善严重感染患者的预后至关重要。本研究旨在评估北欧国家的血培养诊断，并将其与 2013 年在瑞典进行的先前调查进行比较。

方法

设计并于 2018 年 1 月向北欧临床微生物实验室 (CML) ( n  = 76) 分发了一份在线问卷。

结果

响应率为 64% (49/76)。82% 的 CML (40/49) 支持全天候培养血培养 (BCs)，尽管在其中 6 个 CML 中，并非所有集水区的柜子都可以全天候使用培养箱，并且 41% 的站点 (20/49) 没有协助卫星孵化器。几乎一半（49%，24/49）的 CML 在工作日提供 ≥10 小时的开放时间，更常见于年产量 ≥30 000 BCs 的 CML。尽管如此，由于开放时间限制，一天中有 60-70% 的时间未处理阳性 BC。在≥75% 的电话联系中，23% 的 CML (11/48) 给出了治疗建议。在 18% 的 CML (9/49) 中对阳性培养物的等分试样进行快速分析（物种鉴定和药敏试验，孵育时间短）。与 2013 年相比，

结论

CML 已采取行动改进 BC 诊断、实施卫星孵化器、快速物种识别和敏感性测试等方面。然而，有限的开放时间和临床微生物学家的可用性限制了这些变化的优势。