Turning the Tide on Sepsis Diagnostics

When a blood culture turns positive, the laboratory workflow shifts immediately from routine processing to time-critical execution. Gram stain information provides an early signal, but the transition to species identification and antimicrobial susceptibility data still unfolds over a longer timeline.

This gap is well understood. It is also where laboratories are increasingly seeking to gain time, without compromising the reliability and structure that diagnostic workflows depend on.

Bruker is focusing specifically on this part of the process, where improvements in timing can translate directly into greater clinical relevance.

In most laboratories, the pathway remains sequential. Following positivity, subculture is required to obtain isolated colonies, anchoring identification and susceptibility testing to an overnight incubation step.

Approaches direct from positive blood culture (PBC) have already shifted part of this timeline. Using Bruker Arc™ or the MBT Sepsityper^® Kit US IVD, laboratories can process PBC samples immediately and proceed to MALDI-TOF-based identification without waiting for colony growth.

This has changed how quickly species-level results can be obtained. It has also raised a more practical question for many laboratories: if identification can move closer to the moment of positivity, can antimicrobial susceptibility testing (AST) follow?

Even when identification is obtained earlier, susceptibility testing typically remains tied to subculture and overnight incubation. This creates a persistent gap between knowing the organism and understanding how to treat it.

Bruker’s aim is to close this gap by enabling phenotypic susceptibility testing directly from positive blood cultures and bringing actionable results into the same working shift - rather than the next day - while fitting within existing staffing models and without adding complexity.

Bruker Wave™, currently under FDA review and not available for sale in the United States, is being developed within this context.

Susceptibility data only has clinical value if it becomes available while treatment decisions are still evolving. In bloodstream infections, therapy typically starts empirically and is adjusted as microbiological results become available. Delays in effective therapy have been associated with increased mortality, underscoring how closely timing and outcome are linked.^1,2,3

For the laboratory, this places a clear emphasis on delivering AST results at a point where they can still influence treatment decisions, rather than confirming them after the fact.

<sup>1. Kumar A, et al. Crit Care Med. 2006;34(6):1589-1596.
2. Seymour CW, et al. N Engl J Med. 2017;376(23):2235-2244. 
3. Liu VX, et al. Am J Respir Crit Care Med. 2017;196(7):856-863.</sup>

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