Cultures for acid-fast bacilli: are we being good stewards?
Abstract Objective: To describe the use of cultures for acid-fast bacilli (AFB) and situations in which AFB cultures are unlikely to be of clinical benefit. Design: Retrospective descriptive study of AFB cultures submitted to Sentara Health microbiology laboratory from December 1, 2021, to Decem...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X24004637/type/journal_article |
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| author | Jennifer Hanrahan Julie D. Sill Patricia Ver Schneider Jessica F. Copeland Elsie Frimpongmaa Amoako-Kissi Ogochukwu O. Ilobi Angela J. Toepp |
| author_facet | Jennifer Hanrahan Julie D. Sill Patricia Ver Schneider Jessica F. Copeland Elsie Frimpongmaa Amoako-Kissi Ogochukwu O. Ilobi Angela J. Toepp |
| author_sort | Jennifer Hanrahan |
| collection | DOAJ |
| description |
Abstract
Objective:
To describe the use of cultures for acid-fast bacilli (AFB) and situations in which AFB cultures are unlikely to be of clinical benefit.
Design:
Retrospective descriptive study of AFB cultures submitted to Sentara Health microbiology laboratory from December 1, 2021, to December 1, 2023. Data were collected from the electronic medical record and included patient demographics, the service line that ordered the culture, specimen source, and culture results.
Setting:
Sentara Healthcare System.
Patients:
All patients who had specimens submitted to the microbiology laboratory during the study period were included.
Results:
A total of 13,944 AFB cultures from 8,243 patients were collected during the study period. Of these, 4.72% (n = 389) patients had a positive result, and 40 of 680 positive cultures were likely contaminants or non-mycobacterial. The average number of days between culture collection and positive results was 84.32 days (SD = 49.64) and 56.25 days (SD = 8.32) for negative results. Most cultures were ordered by medical subspecialties (44.06%, n = 6,144), followed by orthopedic providers (23.34%, n = 3,254) and surgical subspecialty providers (16.11%, n = 2,246). Most specimens were pulmonary (n = 6,620) with 619 (9.35%) positive cultures. Of 3,561 AFB cultures ordered from bone specimens, only 17 were positive (0.48%). The number of specimens processed by the microbiology laboratory required 2 full-time microbiology technicians to process specimens.
Conclusions:
Many AFB cultures were sent from patients who did not have clinical scenarios consistent with mycobacterial disease and cultures were not clinically indicated. Implementation of testing criteria could decrease AFB cultures and healthcare costs.
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| format | Article |
| id | doaj-art-7a6ca8401eb743c09f9235118c6c1ced |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-7a6ca8401eb743c09f9235118c6c1ced2025-01-16T21:50:44ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01410.1017/ash.2024.463Cultures for acid-fast bacilli: are we being good stewards?Jennifer Hanrahan0https://orcid.org/0000-0002-7443-5985Julie D. Sill1Patricia Ver Schneider2Jessica F. Copeland3Elsie Frimpongmaa Amoako-Kissi4Ogochukwu O. Ilobi5Angela J. Toepp6https://orcid.org/0000-0002-0432-5780Macon and Joan Brock Virginia Health Sciences, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USAMacon and Joan Brock Virginia Health Sciences, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USASentara Health, Enterprise Analytics, Virginia Beach, VA, USASentara Health, Enterprise Analytics, Virginia Beach, VA, USAMacon and Joan Brock Virginia Health Sciences, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USAMacon and Joan Brock Virginia Health Sciences, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USAMacon and Joan Brock Virginia Health Sciences, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USA Sentara Health, Enterprise Analytics, Virginia Beach, VA, USA Abstract Objective: To describe the use of cultures for acid-fast bacilli (AFB) and situations in which AFB cultures are unlikely to be of clinical benefit. Design: Retrospective descriptive study of AFB cultures submitted to Sentara Health microbiology laboratory from December 1, 2021, to December 1, 2023. Data were collected from the electronic medical record and included patient demographics, the service line that ordered the culture, specimen source, and culture results. Setting: Sentara Healthcare System. Patients: All patients who had specimens submitted to the microbiology laboratory during the study period were included. Results: A total of 13,944 AFB cultures from 8,243 patients were collected during the study period. Of these, 4.72% (n = 389) patients had a positive result, and 40 of 680 positive cultures were likely contaminants or non-mycobacterial. The average number of days between culture collection and positive results was 84.32 days (SD = 49.64) and 56.25 days (SD = 8.32) for negative results. Most cultures were ordered by medical subspecialties (44.06%, n = 6,144), followed by orthopedic providers (23.34%, n = 3,254) and surgical subspecialty providers (16.11%, n = 2,246). Most specimens were pulmonary (n = 6,620) with 619 (9.35%) positive cultures. Of 3,561 AFB cultures ordered from bone specimens, only 17 were positive (0.48%). The number of specimens processed by the microbiology laboratory required 2 full-time microbiology technicians to process specimens. Conclusions: Many AFB cultures were sent from patients who did not have clinical scenarios consistent with mycobacterial disease and cultures were not clinically indicated. Implementation of testing criteria could decrease AFB cultures and healthcare costs. https://www.cambridge.org/core/product/identifier/S2732494X24004637/type/journal_article |
| spellingShingle | Jennifer Hanrahan Julie D. Sill Patricia Ver Schneider Jessica F. Copeland Elsie Frimpongmaa Amoako-Kissi Ogochukwu O. Ilobi Angela J. Toepp Cultures for acid-fast bacilli: are we being good stewards? Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Cultures for acid-fast bacilli: are we being good stewards? |
| title_full | Cultures for acid-fast bacilli: are we being good stewards? |
| title_fullStr | Cultures for acid-fast bacilli: are we being good stewards? |
| title_full_unstemmed | Cultures for acid-fast bacilli: are we being good stewards? |
| title_short | Cultures for acid-fast bacilli: are we being good stewards? |
| title_sort | cultures for acid fast bacilli are we being good stewards |
| url | https://www.cambridge.org/core/product/identifier/S2732494X24004637/type/journal_article |
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