2024 Volume 73 Issue 1 Pages 106-114
From August 2019, most microbiological tests in our hospital were changed from outsourced to in-house implementation. Microbiology-testing-related items at one year of outsourcing and one year of in-house implementation were compared. The income/expense ratio increased from 101% to 125%. The total number of specimens identified slightly increased from 6,813 to 6,821. The number of sputum cultures positive for methicillin-resistant Staphylococcus aureus (MRSA) increased from 147 to 293. The number of urine cultures found to be positive for Aerococcus spp. increased from 1 to 33. In the case of drug-resistant bacteria detected, the number of MRSA increased from 230 to 405. For one organism, the number of bacteria tested for drug susceptibility decreased from 1,674 to 1,387. In comparing blood culture tests between the two periods, the positivity rate increased from 11.9% to 12.1%, and the contamination rate decreased from 2.8% to 2.4%. The in-hospital mortality rate of patients with positive blood cultures decreased from 37.3% to 32.6%. Meropenem antimicrobial use density decreased from 0.77 to 0.76, and the number of days of therapy decreased from 1.14 to 1.09. The interval from the arrival of the sample at the laboratory to the final report increased from 4.00 to 4.16 days, except for blood cultures, and decreased from 8.00 to 4.97 days for positive blood cultures. The shift to in-house microbiology testing may contribute to not only the prompt report of the test results and increased accuracies, but also laboratory profitability, patient survival rates, and cost savings in other departments.
