Summary
Blood cultures are among the most important specimen types received and processed
by the microbiology laboratory. Several publications list which variables should be
measured to ensure quality. We undertook a qualitative structured questionnaire of
Australian and New Zealand clinical microbiology laboratories to document current
blood culture practices and to determine whether expected quality standards are being
met. Questions included a wide range of pre-analytical, analytical, and post-analytical
aspects of blood cultures from adults. The responses from 71 laboratories were analysed.
Compliance was high for use of a biological safety cabinet (90%), incubating for 5
days (86%), and commenting on likely contaminants (85%). While Gram stains were reported
within 2 hours during normal hours (93%), reporting was slower after hours (59%),
p<0.001. The volume of blood collected for a clinical episode was poorly monitored
with only 11% (n=8) of laboratories regularly auditing the number of blood culture sets and 3% (n=2) monitoring adequacy of fill. Most laboratories received blood cultures from off-site
with just 34% (n=21) meeting guidance for loading bottles onto the analyser within 4 hours. More laboratories
met standards for loading bottles onto the analyser during working hours than after
hours: 87% vs 56%, p<0.001. Most laboratories did not monitor the contamination rate, 56% (n=40), and only 27% (n=19) knew their rate was below the guidance threshold of less than –3%. Considerable
opportunities exist to improve quality assurance of blood culture practice in Australia
and New Zealand, especially for the most critical aspect affecting culture sensitivity,
the volume of blood collected.
Key words
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Article info
Publication history
Published online: December 23, 2020
Accepted:
September 7,
2020
Received in revised form:
August 26,
2020
Received:
July 30,
2020
Identification
Copyright
© 2020 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.
