I am currently at the ECCMID conference in Barcelona and have been hearing a good bit this morning about rapid identification of organisms following a positive blood culture. This is all very well and good although as usual there was not much about either the logistics or the cost (a lesser priority for conference idealists).

It however got me thinking about all the different time periods that there are from the time the blood culture is taken off the patient until we even start analysing a positive sample.

Significant delays may occur in the following steps:

• From when the Blood culture is taken from patient until it arrives at the laboratory.
• From when the blood culture arrives at the laboratory until it is put into the blood culture analyser.
• The potential delay in a Positive blood culture being removed from the blood culture analyser.

It is difficult to justify expensive post-positive methodologies such as Maldi-tof sepsityper or PNA-FISH if we have significant delays in getting to positivity in the first place. We know that many institutions, if not most, have delays in at least one of these areas.

We need to strive for 24/7 “put-in” and “take-out” of our blood culture analysers.

We hear about the importance of “door to needle” time in treating heart attacks. We need to adopt a similar philosophy for positive blood cultures so that we seek to minimise time delays in all steps, not just the ones with the fancy technology…..

Michael