2163. Clinical Impact of Inter-site Blood Culture Transport in a Canadian Tertiary Care Center

BACKGROUND: The potential delays caused by transport of blood cultures to server laboratories might result in delayed issuance of results for patients with positive blood cultures. In this study, we aimed to determine the clinical impacts of inter-site transport of blood cultures. METHODS: We performed a retrospective cohort study involving cases with positive blood cultures (1 positive blood culture/species/patient/7 days; not deemed as a contaminant) at two sites of a Canadian tertiary care center between January 1, 2018 and December 31, 2018. Blood cultures from the affiliated site were transported to the laboratory of the primary server site. These two sites are located 8 km apart. The following outcomes were studied: the duration between blood culture sampling and issuance of the first report and the duration between blood culture sampling and administration of the first effective antibiotic. RESULTS: We observed 349 episodes of bacteremia, including 161 in the affiliated site (45.5%) and 193 in the primary server center (54.5%). Enterobacteriaceae (n = 151, 43%) and Staphylococcus aureus (n = 77, 22%) were the most commonly observed causative bacteria. Median duration for issuance of the first positive report was significantly shorter in the primary server hospital (32.4 h, interquartile range [IQR] 19.8–44.3) than in the affiliated center (37.9 h, IQR 24.1–46.5; P = 0.004). The median duration between blood culture sampling and administration of the first effective antibiotic was 2.7 h in the server site (IQR 0.75–15.2) and 2.3 h in the affiliated site (IQR 1–8.45) (P = 1.0). Receiving the first effective antibiotic after blood culture sampling required > 60 min in 8/189 patients (4.2%) in the affiliated site and 9/158 patients (5.7%) in the primary server site (P = 0.3). The 30-day mortality was 13.8% (26/189) and 8.9% (14/158) at the primary server site and affiliated site, respectively (P = 0.16). CONCLUSION: Inter-site transport of blood cultures is associated with a significant delay in the issuance of positive blood culture reports. However, this delay does not cause any delay in administration of effective antibiotic therapy because of rapid recognition of sepsis in bacteremia patients. These results are reassuring in the context of increasing microbiology service centralization. DISCLOSURES: All authors: No reported disclosures.