Outcomes of Improved Anaerobic Techniques in Clinical Microbiology

To our knowledge, the effects of the use of improved anaerobic techniques have not been documented. We compared data on patients during 2 different time periods-the first when anaerobic cultures were done by standard techniques (the control or "before" group) and the second when anaerobic cultures were done after an intensive program to improve anaerobic techniques (IAT). The program consisted of the use of an anaerobe chamber, improved anaerobic transport and media, and education of clinicians and microbiologists. There were 74 diagnosis-related group (DRG)-matched patients in the controls and 76 in the IAT group. The average turnaround time for preliminary anaerobic data was decreased in the IAT group (124 hours per specimen for controls and 107 for IAT, P=.001). The cost of achieving anaerobic conditions for a plate was approximately $0.09 when the anaerobic chamber was used and $0.96 when the bio-bag system was used. The crude mortality rate was 10.8% in controls and 1.3% in the IAT group (P=.06). The average length of stay was 10.2 days per patient in controls and 8.9 in the IAT group (P=.91). The average variable cost was $6865 per patient in the control group and $4432 in the IAT group (P=.21). The average laboratory cost was $723 per patient in the control group and $380 in the IAT group (P=.08). In conclusion, benefits associated with improved anaerobic testing were documented. We could expect to save >$630,000 every year with improved anaerobic processes.