Case report: Critical point analysis of the delays in blood culture diagnosis of candidemia

In a secondary care hospital in Germany with an in-house microbiology laboratory, an 84-year-old female patient with candidemia was selected for determination of the time periods required for each diagnostic step preceding the application of the first dose of antimycotic treatment. The total time from the beginning of fever to the first dose of fluconazole was 25 hours and 10 minutes. The largest delay occurred between the positive signal of the blood culture bottle during the night and the start of the work-up of the positive blood culture bottle in the morning. Improvements appear to be possible in both clinical and laboratory settings by optimizing pre-analytical, analytical, and post-analytical procedures.