Multifactorial impacts of blood culture process optimization on clinical outcomes and healthcare economics in bloodstream infection management

Objective To investigate the clinical and health economic impacts of individual workflow components. The effects of phased process optimizations were quantified using empirical data. Methods From August 2023 to October 2024, the outcomes before and after workflow optimization were compared. The control group comprised patients processed under conventional protocols, while the experimental group included those managed with optimized workflows. Results Phase I revealed significant temporal reductions through MALDI-TOF enhanced biofilm identification. The Gram-stain reporting time decreased from 33.3 h to 25.7 h ( P < 0.05), species identification from 72.5 h to 42.6 h ( P < 0.05). Phase II implementation of 24/7 processing via BacT/Alert Virtuo achieved marked improvements across all metrics, namely Gram-stain (37.4 h vs, 17.9 h), identification (42.6 h vs. 36.4 h) and AST reporting (68.4 h vs. 63.4 h) (all P < 0.05). Phase III optimization through Advanced Expert System (AES)-enabled automated preliminary AST reporting during off-hours significantly accelerated therapeutic guidance (63.4 h vs. 47.2 h, P < 0.05). Conclusion Quantitative analysis of these optimizations elucidated their differential impacts on blood culture workflows and prognostic determinants. These findings advocate for laboratory innovation as a driver of antimicrobial stewardship and precision medicine for management of microbial bloodstream infections.