Infrastructure and current practice of blood culture diagnostics in patients with sepsis: teachings and recommendations from the European Sepsis Care Survey

The recently published European Sepsis Care Survey (ESCS) by the European Sepsis Alliance (ESA) showed that the standard-of-care strategies regarding infrastructure and logistics on diagnosis and management of sepsis were beyond what is considered satisfactory. This led to a position statement by the Steering Committee of the ESA. A literature search was conducted to compare the compliance with the Surviving Sepsis Campaign Guidelines and/or other medical societies reported by the health care practitioners participating in the ESCS regarding first line fluids and vasopressors, biomarkers, continuous availability for microbiology service and antibiotic stewardship team. In all suggested practices for sepsis care the feedback of the health-care professionals who completed the ESCS showed that the average adherence was more than 80% with two exceptions: availability of microbiology diagnosis limited to 10% and antibiotic stewardship for the selection of the most appropriate antibiotic limited to 65%. ESA suggests that quality measures are applied across Europe towards the implementation of bundles for early sepsis recognition, antibiotic stewardship for sepsis patients and availability of a continuous microbiology service on a 24-hour basis including weekends for timely diagnosis.