A prospective study on the effect of time-shifted telephone reporting of blood culture microscopy

  • T. GehringEmail author
  • H. Kim
  • A. Hoerauf
  • C. Buechler
Original Article


Even though dealing with septic patients, the communication of the Gram stain result of positive blood cultures is postponed in most laboratories outside of conventional working hours. There is little evidence from clinics that this issue is being addressed. This study evaluates the potential benefit of an around-the-clock communication. Therefore, the effect of the communication on the antibiotic treatment and the delay of the communication during our non-office hours were measured. Over a three-month period, all blood cultures which were positive for the first time outside the normal working hours were analyzed. Two standardized telephone calls were used to compare the antibiotic treatment before and after the communication of the Gram stain result. The evaluation of the antibiotic treatment was based on the final testing result. In total, 135 patients were included. The rate of the adequate antibiotic increased by 8 percentage points to 69%. The average delay in the patients adjusted to an adequate treatment was 8:57 h (range 2:16–16:59). This prospective study shows a benefit of the immediate communication. Nevertheless, this benefit seems to be partly the result of suboptimal adherence to the guidelines regarding empirical antibiotic treatment. This prospective study has been registered in the German Clinical Trials Register under the identifier DRKS00014996 (


Blood culture Antibiotic treatment Gram stain Microscopy Communication 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

No approval required according to the ethic committee of the University of Bonn.

Informed consent

No approval required according to the ethic committee of the University of Bonn.


  1. 1.
    Rhodes A et al (2017) Surviving sepsis campaign: international guidelines for management of sepsis and Septic shock: 2016. Intensive Care Med 43(3):304–377CrossRefGoogle Scholar
  2. 2.
    Goel G et al (2015) A method for early detection of antibiotic resistance in positive blood cultures: experience from an oncology centre in eastern India. Indian J Med Microbiol 33(Suppl):53–58Google Scholar
  3. 3.
    Jo SJ et al (2016) Direct identification and antimicrobial susceptibility testing of bacteria from positive blood culture bottles by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and the Vitek 2 system. Ann Lab Med 36(2):117–123CrossRefGoogle Scholar
  4. 4.
    Barenfanger J et al (2008) Decreased mortality associated with prompt gram staining of blood cultures. Am J Clin Pathol 130(6):870–876CrossRefGoogle Scholar
  5. 5.
    Beekmann SE et al (2003) Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges. J Clin Microbiol 41(7):3119–3125CrossRefGoogle Scholar
  6. 6.
    Cunney RJ et al (1997) The impact of blood culture reporting and clinical liaison on the empiric treatment of bacteraemia. J Clin Pathol 50(12):1010–1012CrossRefGoogle Scholar
  7. 7.
    Moore JS, Koerner RJ (2015) In the era of the 24 h laboratory, does communicating gram stain results from blood cultures flagging positive outside of conventional working hours alter patient management? J Clin Pathol 68(11):938–941CrossRefGoogle Scholar
  8. 8.
    Jindai K et al (2014) Is a single positive blood culture for Enterococcus species representative of infection or contamination? Eur J Clin Microbiol Infect Dis 33(11):1995–2003CrossRefGoogle Scholar
  9. 9.
    Garnacho-Montero J et al (2015) Adequate antibiotic therapy prior to ICU admission in patients with severe sepsis and septic shock reduces hospital mortality. Crit Care 19:302CrossRefGoogle Scholar
  10. 10.
    Riedel S et al (2006) Comparison of the BACTEC 9240 and BacT/alert blood culture systems for detection of bacterial contamination in platelet concentrates. J Clin Microbiol 44(6):2262–2264CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Medical Microbiology, Immunology and ParasitologyUniversity Hospital of BonnBonnGermany

Personalised recommendations