OBJECTIVES: To estimate the economic and clinical outcomes of time to detection and positivity rates of bloodstream infections (BSI) when implementing BACT/ALERT® VIRTUO® (VIRTUO) system compared to BD BACTEC™ FX (FX).

METHODS: A decision tree was developed to estimate length of stay (LOS), mortality and cost differences between VIRTUO and FX blood culture detection systems. Time to detection (TTD) and turnaround time (TAT) were derived from the literature and used to estimate time to start of antibiotic treatment (for patients not on empirical treatment) and to transition patients to effective therapy. Mortality and LOS were estimated based on time to appropriate treatment. Additionally, differences in positivity rates between both systems were used to estimate the proportion of patients with missed diagnoses who were assumed to be at risk of developing septic shock (34% of patients). Laboratory resource utilization was derived from the literature and labor costs were applied to assess efficiencies between the systems. Blood cultures were collected and evaluated from an initial cohort of 28 patients per day.

RESULTS: Estimated mortality among patients with BSI was 18.03% for VIRTUO and 19.67% for FX (difference of 1.65%). Total costs and LOS for patients with BSI was $39,873.44 and 35.1 days respectively for VIRTUO compared to $40,502.38 and 35.2 days respectively for FX, resulting in a 0.2 day LOS reduction and savings of $628.95.

Per day laboratory savings from workflow improvements were $6.99 with VIRTUO. The total cost savings when extrapolated for a month and year were $17,610 for 770 patients tested and $229,723 for 10,044 patients tested, respectively, for VIRTUO.

CONCLUSIONS: This study shows that use of VIRTUO may reduce mortality, hospitalization costs, and LOS, within a one-year timeframe due to faster TTD/TAT and increased positivity, while decreasing laboratory costs due to the reduced hands-on time required to operate VIRTUO.