Blood culture practices and microbiological capacity for sepsis diagnostics in Europe (2021–2022) : a cross-sectional analysis of the European Sepsis Care Survey
(2026) In The Lancet Regional Health - Europe 62.- Abstract
Background: Blood cultures (BCs) are key diagnostic elements for sepsis patients. Accurate preanalytical procedures are substantial, and results should be available as soon as possible to guide adequate antimicrobial treatment. This study aimed to evaluate BC collection practices and diagnostic capacity across European hospitals. Methods: This cross-sectional survey investigated BC diagnostics in acute care hospitals across 37 European countries in the years 2021 and 2022. Analyses included BC guidelines, collection sites, number of BC sets in emergency departments (EDs), wards, and intensive care units (ICUs). We also examined transfer after collection, the use of on-site vs. external laboratories, opening hours, rapid testing... (More)
Background: Blood cultures (BCs) are key diagnostic elements for sepsis patients. Accurate preanalytical procedures are substantial, and results should be available as soon as possible to guide adequate antimicrobial treatment. This study aimed to evaluate BC collection practices and diagnostic capacity across European hospitals. Methods: This cross-sectional survey investigated BC diagnostics in acute care hospitals across 37 European countries in the years 2021 and 2022. Analyses included BC guidelines, collection sites, number of BC sets in emergency departments (EDs), wards, and intensive care units (ICUs). We also examined transfer after collection, the use of on-site vs. external laboratories, opening hours, rapid testing capacity, and turn-around times of BCs processed in microbiology laboratories with different infrastructures. Findings: Responses were collected from 907 hospitals in Europe. BC guidelines were available in 84·4% (741/878) of the hospitals. BCs were preferably collected by multiple-site sampling in EDs (62·7%, 461/735), in wards (64·0%, 513/802) and ICUs (68·5%, 518/756). One BC set was preferred in EDs in 38·4% (270/704), in wards in 40·5% (314/775), and ICUs in 34·9% (261/748). Two BC sets were preferred in EDs in 31·0% (218/704), in wards in 28·1% (218/775), and ICUs in 39·2% (293/748). 48·0% (402/838) of hospitals used on-site and 52·0% (436/838) external microbiology laboratories. Around-the-clock microbiological services were available in 10⋅0% (91/907), and rapid pathogen identification in 43·7% (396/907) of hospitals. Infrastructure with around-the-clock microbiological service and rapid testing was available in 7·4% (62/840) of hospitals, and probability of a final microbiological result within two days was highest in these hospitals compared to hospitals with limited microbiology service (for BC collected on wards: 19·6% vs. 52·7%, Odds Ratio 4·59 [95% CI 2·50–7·79], p < 0·0001). Interpretation: Despite the availability of BC guidelines in many hospitals, current recommendations for BC collection were often neglected. Rapid testing capacity was limited in most microbiological laboratories, and around-the-clock service for BCs was very rare. As delay in results may have a detrimental impact on patient outcomes, strategies to improve these processes are urgently needed. Funding: The European Sepsis Alliance and a grant by Becton and Dickinson.
(Less)
- author
- organization
- publishing date
- 2026-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Blood culture analysis, Blood cultures, Clinical practice, Diagnostics, Infrastructure, Multiple-site sampling, Number of blood cultures sets, Opening hours, Pre-analytical practice, Rapid testing, Sepsis, Single-site sampling, Turn-around time
- in
- The Lancet Regional Health - Europe
- volume
- 62
- article number
- 101570
- publisher
- Elsevier
- external identifiers
-
- scopus:105027568755
- pmid:41502864
- ISSN
- 2666-7762
- DOI
- 10.1016/j.lanepe.2025.101570
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2025 The Author(s)
- id
- fc473a64-b7f5-471b-88e0-71f3289a0ccd
- date added to LUP
- 2026-03-23 14:47:35
- date last changed
- 2026-05-04 19:37:27
@article{fc473a64-b7f5-471b-88e0-71f3289a0ccd,
abstract = {{<p>Background: Blood cultures (BCs) are key diagnostic elements for sepsis patients. Accurate preanalytical procedures are substantial, and results should be available as soon as possible to guide adequate antimicrobial treatment. This study aimed to evaluate BC collection practices and diagnostic capacity across European hospitals. Methods: This cross-sectional survey investigated BC diagnostics in acute care hospitals across 37 European countries in the years 2021 and 2022. Analyses included BC guidelines, collection sites, number of BC sets in emergency departments (EDs), wards, and intensive care units (ICUs). We also examined transfer after collection, the use of on-site vs. external laboratories, opening hours, rapid testing capacity, and turn-around times of BCs processed in microbiology laboratories with different infrastructures. Findings: Responses were collected from 907 hospitals in Europe. BC guidelines were available in 84·4% (741/878) of the hospitals. BCs were preferably collected by multiple-site sampling in EDs (62·7%, 461/735), in wards (64·0%, 513/802) and ICUs (68·5%, 518/756). One BC set was preferred in EDs in 38·4% (270/704), in wards in 40·5% (314/775), and ICUs in 34·9% (261/748). Two BC sets were preferred in EDs in 31·0% (218/704), in wards in 28·1% (218/775), and ICUs in 39·2% (293/748). 48·0% (402/838) of hospitals used on-site and 52·0% (436/838) external microbiology laboratories. Around-the-clock microbiological services were available in 10⋅0% (91/907), and rapid pathogen identification in 43·7% (396/907) of hospitals. Infrastructure with around-the-clock microbiological service and rapid testing was available in 7·4% (62/840) of hospitals, and probability of a final microbiological result within two days was highest in these hospitals compared to hospitals with limited microbiology service (for BC collected on wards: 19·6% vs. 52·7%, Odds Ratio 4·59 [95% CI 2·50–7·79], p < 0·0001). Interpretation: Despite the availability of BC guidelines in many hospitals, current recommendations for BC collection were often neglected. Rapid testing capacity was limited in most microbiological laboratories, and around-the-clock service for BCs was very rare. As delay in results may have a detrimental impact on patient outcomes, strategies to improve these processes are urgently needed. Funding: The European Sepsis Alliance and a grant by Becton and Dickinson.</p>}},
author = {{Scheer, Christian S. and Giamarellos-Bourboulis, Evangelos J. and Annane, Djillali and Artigas, Antonio and Tarik Aslan, Abdullah and Bottari, Gabriella and Bouma, Hjalmar R. and Černý, Vladimir and Curić Radivojević, Renata and Dewitte, Ken and Filipescu, Daniela and Gründling, Matthias and Hästbacka, Johanna and Laribi, Said and Lassen, Annmarie and Lebedinskii, Konstantin and Linder, Adam and Máca, Jan and Malbrain, Manu L.N.G. and Monti, Gianpaola and Ostermann, Marlies and Osthoff, Michael and Paiva, José Artur and Sabbatucci, Michela and Śmiechowicz, Jakub and Ştefan, Mihai Gabriel and Vollmer, Marcus and Vuković, Natalija and Zaragkoulias, Kyriakos and Reinhart, Konrad and Ferrer, Ricard and Idelevich, Evgeny A.}},
issn = {{2666-7762}},
keywords = {{Blood culture analysis; Blood cultures; Clinical practice; Diagnostics; Infrastructure; Multiple-site sampling; Number of blood cultures sets; Opening hours; Pre-analytical practice; Rapid testing; Sepsis; Single-site sampling; Turn-around time}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{The Lancet Regional Health - Europe}},
title = {{Blood culture practices and microbiological capacity for sepsis diagnostics in Europe (2021–2022) : a cross-sectional analysis of the European Sepsis Care Survey}},
url = {{http://dx.doi.org/10.1016/j.lanepe.2025.101570}},
doi = {{10.1016/j.lanepe.2025.101570}},
volume = {{62}},
year = {{2026}},
}