Laboratory workflow analysis of culture of periprosthetic tissues in blood culture bottles

Trisha N. Peel, John A. Sedarski, Brenda L. Dylla, Samantha K. Shannon, Fazlollaah Amirahmadi, John G. Hughes, Allen C. Cheng, Robin Patel

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Culture of periprosthetic tissue specimens in blood culture bottles is more sensitive than conventional techniques, but the impact on laboratory workflow has yet to be addressed. Herein, we examined the impact of culture of periprosthetic tissues in blood culture bottles on laboratory workflow and cost. The workflow was process mapped, decision tree models were constructed using probabilities of positive and negative cultures drawn from our published study (T. N. Peel, B. L. Dylla, J. G. Hughes, D. T. Lynch, K. E. Greenwood-Quaintance, A. C. Cheng, J. N. Mandrekar, and R. Patel, mBio 7:e01776-15, 2016, https://doi.org/10.1128/mBio.01776-15), and the processing times and resource costs from the laboratory staff time viewpoint were used to compare periprosthetic tissues culture processes using conventional techniques with culture in blood culture bottles. Sensitivity analysis was performed using various rates of positive cultures. Annualized labor savings were estimated based on salary costs from the U.S. Labor Bureau for Laboratory staff. The model demonstrated a 60.1% reduction in mean total staff time with the adoption of tissue inoculation into blood culture bottles compared to conventional techniques (mean ± standard deviation, 30.7 ± 27.6 versus 77.0 ± 35.3 h per month, respectively; P < 0.001). The estimated annualized labor cost savings of culture using blood culture bottles was $10,876.83 (±$337.16). Sensitivity analysis was performed using various rates of culture positivity (5 to 50%). Culture in blood culture bottles was cost-effective, based on the estimated labor cost savings of $2,132.71 for each percent increase in test accuracy. In conclusion, culture of periprosthetic tissue in blood culture bottles is not only more accurate than but is also cost-saving compared to conventional culture methods.

Original languageEnglish (US)
Pages (from-to)2817-2826
Number of pages10
JournalJournal of clinical microbiology
Volume55
Issue number9
DOIs
StatePublished - Sep 2017

Keywords

  • Diagnosis
  • Laboratory costs
  • Laboratory workflow
  • Prosthetic joint infection
  • Semiautomated

ASJC Scopus subject areas

  • Microbiology (medical)

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  • Cite this

    Peel, T. N., Sedarski, J. A., Dylla, B. L., Shannon, S. K., Amirahmadi, F., Hughes, J. G., Cheng, A. C., & Patel, R. (2017). Laboratory workflow analysis of culture of periprosthetic tissues in blood culture bottles. Journal of clinical microbiology, 55(9), 2817-2826. https://doi.org/10.1128/JCM.00652-17