A prospective study evaluating the impact of a "Diagnostic Stewardship Care-Bundle" for automated blood culture diagnostics

We prospectively implemented a diagnostic stewardship care-bundle checklist: "Sepsis-48 DSB" with the aim of reducing intervening duration of key steps of automated blood culture diagnostics (aBCD). Sepsis-48 DSB was implemented for automated blood culture bottles (BCBs) received from adult intensive care units (AICUs) during intervention period (P2), July 2020-June 2021 and intervening durations were compared with those during the retrospective, pre-intervention period (P1), March-June 2020. During both periods, provisional blood culture reports (pBCR) were issued wherein direct microbial identification (dID) was performed in BCBs with gram-negatives by directly inoculating conventional biochemical tests and direct antimicrobial susceptibility testing (dAST) using EUCAST RAST method. The results were compared with the standard of care (SoC) method i.e. full incubation followed by identification & AST by VITEK®-2 Compact. During P2, significant reductions in loading time (LT) [median: 63.5 vs 32 minutes, P