Infrastructure and current practice of blood culture diagnostics in patients with sepsis: teachings and recommendations from the European Sepsis Care Survey

Abstract

Introduction: The recently published European Sepsis Care Survey (ESCS) by the European Sepsis Alliance (ESA) showed that the standard-of-care strategies regarding infrastructure and logistics on diagnosis and management of sepsis were beyond what is considered satisfactory. This led to a position statement by the Steering Committee of the ESA. Methods: A literature search was conducted to compare the compliance with the Surviving Sepsis Campaign Guidelines and/or other medical societies reported by the health care practitioners participating in the ESCS regarding first line fluids and vasopressors, biomarkers, continuous availability for microbiology service and antibiotic stewardship team. Results: In all suggested practices for sepsis care the feedback of the health-care professionals who completed the ESCS showed that the average adherence was more than 80% with two exceptions: availability of microbiology diagnosis limited to 10% and antibiotic stewardship for the selection of the most appropriate antibiotic limited to 65%. Conclusions: ESA suggests that quality measures are applied across Europe towards the implementation of bundles for early sepsis recognition, antibiotic stewardship for sepsis patients and availability of a continuous microbiology service on a 24-hour basis including weekends for timely diagnosis.