ArticleCureus2026
Contribution of Laboratory Centralisation to Delays in Blood Culture Handling and Determination of Results.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
INTRODUCTION AND
aimsEarly clinical diagnosis and prompt initiation of antimicrobial therapy have been widely recognised as being crucial to survival from sepsis, but the critical supportive role played by clinical microbiology services is less well recognised. Minimising pre-analytical delay of blood cultures yields early results which support the effective and targeted management of sepsis, while delayed results lead to the prolonged use of empiric broad-spectrum antimicrobial therapy which is considered a causal factor in the emergence of antimicrobial resistance. This study is limited to England and aims to study compliance with a four-hour, pre-analytical delay standard by clinical microbiology services. The study further aims to appraise the impact of laboratory centralisation on microbiology services.
methodsThis is a retrospective observational study over a single year. Retrospective audit data was obtained through freedom of information requests. Information regarding service configurations and costs during that period was also obtained and supplemented by data available in the public domain.
resultsData relating to 149 acute hospitals showed poor rates of compliance, with only 2.7% (n=4) showing full compliance with the recommended standard. Compliance rates showed wide variations between hospitals across the region and within the same administrative unit. Service configurations were not standardised, and quality requirements were not met. Anticipated savings were not realised.
conclusionsPoor rates of compliance with the pre-analytical delay standard are likely to adversely affect patient outcomes from sepsis and impact on antimicrobial stewardship. Laboratory centralisation strategies failed to address the particular needs of the microbiology service. Remedial action is required, with a view to establishing a more comprehensive microbiology service in each acute care setting. Changes are justified in view of the continued high mortality associated with sepsis and the increasing emergence of antimicrobial resistance.
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