ORCID

0000-0002-7443-5985 (Hanrahan), 0000-0002-0432-5780 (Toepp)

Document Type

Article

Publication Date

2025

DOI

10.1017/ash.2024.463

Publication Title

Antimicrobial Stewardship & Healthcare Epidemiology

Volume

4

Issue

1

Pages

e226 (1-6)

Abstract

Objective: To describe the use of cultures for acid-fast bacilli (AFB) and situations in which AFB cultures are unlikely to be of clinical benefit.

Design: Retrospective descriptive study of AFB cultures submitted to Sentara Health microbiology laboratory from December 1, 2021, to December 1, 2023. Data were collected from the electronic medical record and included patient demographics, the service line that ordered the culture, specimen source, and culture results.

Setting: Sentara Healthcare System.

Patients: All patients who had specimens submitted to the microbiology laboratory during the study period were included.

Results: A total of 13,944 AFB cultures from 8,243 patients were collected during the study period. Of these, 4.72% (n = 389) patients had a positive result, and 40 of 680 positive cultures were likely contaminants or non-mycobacterial. The average number of days between culture collection and positive results was 84.32 days (SD = 49.64) and 56.25 days (SD = 8.32) for negative results. Most cultures were ordered by medical subspecialties (44.06%, n = 6,144), followed by orthopedic providers (23.34%, n = 3,254) and surgical subspecialty providers (16.11%, n = 2,246). Most specimens were pulmonary (n = 6,620) with 619 (9.35%) positive cultures. Of 3,561 AFB cultures ordered from bone specimens, only 17 were positive (0.48%). The number of specimens processed by the microbiology laboratory required 2 full-time microbiology technicians to process specimens.

Conclusions: Many AFB cultures were sent from patients who did not have clinical scenarios consistent with mycobacterial disease and cultures were not clinically indicated. Implementation of testing criteria could decrease AFB cultures and healthcare costs.

Rights

© The Authors, 2025

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

Original Publication Citation

Hanrahan, J., Sill, J. D., Ver Schneider, P., Copeland, J. F., Frimpongmaa Amoako-Kissi, E., Ilobi, O. O., & Toepp, A. J. (2025). Cultures for acid-fast bacilli: Are we being good stewards? Antimicrobial Stewardship & Healthcare Epidemiology, 4(1), 1-6, Article e226. https://doi.org/10.1017/ash.2024.463

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