DO BLOOD CULTURES NEED CONTINUOUS MONITORING SO THAT CLINICAL ACTION CAN BE TAKEN OUTSIDE NORMAL WORKING HOURS

Many automated blood culture reading systems monitor bacterial growth 24 hours a day but it is unclear if reacting to prompts indicating bac terial growth outside normal laboratory hours is of clinical benefit. An analysis of 50 blood cultures from 43 patients which had organisms seen on Gram films and had triggered positive out-of-hours showed that examination of the Gram film altered management of seven patients and the results of culture or sensitivity testing altered that of a furth er four. However, after review, it was felt the clinical outcome would not have been influenced by earlier intervention in any of these pati ents. We therefore consider that an out-of-hours service for dealing w ith positive blood cultures is not justified in our hospital. This con clusion may not apply universally, especially in hospitals where poten tial pathogens show less predictable antimicrobial sensitivity pattern s.