Showing posts from May, 2018

Blood cultures - how many sets? how many bottles?

So until last week I thought all microbiologists agreed that we should aspire to 2 sets of blood cultures. I now discover that some people not only think that 2 sets is overkill, they also are happy with just one bottle! There seems some doubt as to whether this should be the aerobic or anaerobic. Anyway, made me look at our data. I’m sure others have done likewise. Be interesting to combine experiences… Effect of multiple sets on positivity rate (significant growth only) So we now get 2 sets of blood cultures sent from the ED in about 20% of cases. And the second set does not add a huge amount of value. 90% of positive episodes in which 2 sets were taken were positive in both sets Taking a second set of cultures probably increases coliform detection by about 5-10% There was little effect on isolation of other significant organisms Bottle type and positivity Looking at all significant culture results, which bottles were positive? 674 / 1053 significant blood cultures w

Blood cultures and GIRFT - some suggestions for comparative metrics

The Get It Right First Time programme in the UK is about to start the pathology disciplines. In essence, GIRFT looks to take clinically relevant data on performance to demonstrate unwarranted variation. Data can be used by local teams to show excellence show practice in line with peers show performance below that of peers In this latter scenario, this can be used to show the need for changes in practice or resourcing, or may be used as part of an conscious decision of risk management based on local exigencies. In order for GIRFT to be successful it is essential that clinically relevant metrics are chosen by the profession. It is not always clear what data will be available, but it is useful to start by considering what might be useful and then working from there. Blood cultures are a mainstay of microbiology and are seen as a core part of a ''diagnostic stewardship" programme in which culture and sensitivity information is used to optimise patient infectio