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Cited by 250Bacterial Identification and Susceptibility TestingClinical Laboratory Practices and Quality ControlSepsis Diagnosis and Treatment

Bloodstream infections – Standard and progress in pathogen diagnostics

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Lamy, Brigitte, Sundqvist, Martin, Idelevich, Evgeny A.·2020·Clinical Microbiology and Infection
DOI 10.1016/j.cmi.2019.11.017
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Abstract

Background Bloodstream infection (BSI) is a major public health burden worldwide, with high mortality. Patient outcome is critically influenced by delayed therapy, and fast and accurate pathogen diagnostics decisively improves the care of patients. During the past two decades major improvements have been made in the diagnostic performance of blood culture diagnostics through actions on pre-analysis and time to result. Aims To review and discuss the literature for standard procedures and the progress in BSI pathogen diagnostics, and to propose a new mindset to reach an improved diagnostic workflow. Sources Scientific articles and reviews available through NCBI/Pubmed. Content Blood culture performance relies largely on the quality of its pre-analytical phase that is improved with educational actions monitored by using key performance indicators, and external quality assessment. Advanced blood culture systems now provide tools for an automated estimation of bottle filling. These proved efficient to facilitate effective training for improving blood collection. On analytic aspects, rapid methods for pathogen identification, among which matrix-assisted laser desorption/ionization time of flight mass spectrometry dominates, and rapid antimicrobial susceptibility testing are reviewed. These technical developments call for improvements in all other steps, especially in pre- and post-analytic logistics to give the full reciprocation of these techniques on patient management. This aspect is summarized by the term 'microbiologistics', which covers all possible improvements in the logistic chain from sampling to report. Implications Progress in BSI pathogen diagnostics is based on a bundle approach that includes optimization of the pre-analytical parameters, rapid start of incubation, the use of rapid methods, re-organization (e.g. 24/7, transportation service) and a close involvement of antimicrobial stewardship teams. These developments lead to define a new standard for bloodstream infection diagnostics.

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  • Progress in BSI management is based on a bundle approach, including optimisation of pre-analytical parameters, use of rapid methods, laboratory organisation, and involvement of antimicrobial stewardship teams.

    “As highlighted by Lamy, et al.., progress in BSI management is based on a bundle approach, including the optimisation of the pre-analytical parameters, the use of rapid methods, laboratory organisation (e.g., 24/7, transportation service) and the involvement of antimicrobial stewardship teams [20].”

    From Lab efficiency and improvements in the management of bloodstream infections: a before and after study (2025) · cites this paper as [20]

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Cited by

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Authors
Lamy, B., Sundqvist, M., & Idelevich, E. A.
Affiliations
  • Inserm (FR)
  • Örebro University (SE)
  • University Hospital Münster (DE)
Corresponding author
Lamy, Brigitte
ORCID
Venue
Clinical Microbiology and Infection
Publisher
Elsevier BV
Published
2020-02
Volume
26
Issue
2
Pages
142-150
ISSN
1198-743X (ISSN-L)
DOI
10.1016/j.cmi.2019.11.017
OpenAlex
W2990542233
Cited by
250
References
1
Citations by year
2026: 35 · 2025: 64 · 2024: 39 · 2023: 41 · 2022: 36 · 2021: 24 · 2020: 8 · 2019: 1
FWCI
2.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Microbiology and Infection (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by-nc)
Funders
Westfälische Wilhelms-Universität Münster
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
bloodstream infection, pathogen identification, MALDI-TOF mass spectrometry, antimicrobial susceptibility testing, pre-analytical phase, external quality assessment, key performance indicators, antimicrobial stewardship, diagnostic workflow
MeSH terms
Blood Culture, Anti-Bacterial Agents, Bacteria, Humans, Microbial Sensitivity Tests, Time Factors, Bacteremia, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Clinical Laboratory Techniques

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