The Microbiology Laboratory of the Regional University Hospital of Málaga has introduced information on positive blood cultures 24 hours a day, 7 days a week. The implementation of rapid diagnostic techniques (TDR) has in many cases made it possible to identify the bacteria and to know the resistance mechanism, if any, 12 hours before the extraction of blood cultures, which facilitates the prescription of the most appropriate treatment. . patients. Patients who need it improve the prognosis.
Until a few months ago, the results and reports of these analyzes were received in 48 hours, which has reduced the time to less than half. When the sample arrives at the laboratory, technicians process it, and when positive, they use mass spectrometry (MALDI ToF) to identify the type of microorganism to be treated, as well as to determine the colorimetric and/or To perform a Gram stain. Immunochromatographic tests to detect possible resistance mechanisms. Molecular tests are also performed to expand this information.
Head of the Microbiology Service, Begona Palop, explains that “this strategy has proved fundamental because we verified that multiple blood cultures were found to be positive by the automated system overnight.”
Several studies have confirmed the importance of processing positive blood cultures of patients with sepsis and septic shock over the course of 24 hours and immediately informing their doctors of the results, because of the rapid establishment of adequate antibiotic therapy for the survival of these patients. improves. “Every hour of delay in correct antibiotic treatment increases mortality by 7.6%. For this reason, knowledge of the etiological agent of said process, as well as its antibiotic sensitivity, is important information for prognosis”, explains Palop.
In addition, the Infection Commission of the Regional University Hospital of Málaga has this summer launched the ‘Sepsis Code’, a consensus document prepared by the various specialties involved in the management of this pathology. Microbiology has collaborated by applying TDR to diagnose bacteria or fungi and its most severe clinical form, sepsis, 24 hours a day, 7 days a week, and reduce the time taken to release results, which is the most Allows to establish effective antibiotic treatment according to the microorganism, the source of infection, the patient’s condition and existing co-morbidities, which means improving the care of critically ill patients affected by this pathology.
“The 24-hour operation of the laboratory contributes to better epidemiological control and surveillance, reduces the presence of superinfection in the most vulnerable patients, optimizes the appropriate use of currently available technology and enables real-time information on alarm conditions. makes it possible to do”, concluded Dr. Begona Palop.