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Objectives: Eggerthella lenta is a Gram-positive anaerobic bacillus that is an important cause of bloodstream infections. This study aims to test the susceptibility of Eggerthella lenta blood culture isolates to commonly used antibiotics for the empirical treatment of anaerobic infections., Methods: In total, 49 positive blood cultures for Eggerthella lenta were retrospectively included from patients hospitalised at the Universitair Ziekenhuis Brussel, Belgium, between 2004 and 2018. Identification was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system. Antimicrobial susceptibility testing was performed using the reference agar dilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines with Brucella agar supplemented with 5 μg/mL hemin, 1 μg/mL vitamin K1 and 5% laked sheep blood. The minimal inhibitory concentrations were interpreted using the EUCAST breakpoints. Clinical characteristics were collected by reviewing the patient's medical records., Results: All isolates were susceptible to amoxicillin-clavulanate, metronidazole and meropenem. Eighty-eight % of them were susceptible to clindamycin and 94% (20% S, 74% I) were susceptible to piperacillin-tazobactam. The mean age of the patients was 64 (±20) and they showed a 30-day mortality of 27%. The source of infection was in 65.3% of the cases abdominal, 20.4% were sacral pressure ulcers and 14.3% were unknown causes. While all isolates were fully susceptible at standard dosing regimen to amoxicillin-clavulanate, most were only susceptible at increased exposure or resistant to piperacillin-tazobactam., Conclusions: Our results suggest to be careful with the use of piperacillin-tazobactam and clindamycin in the empirical treatment of Eggerthella lenta infections., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Ojectives: Since health care budgets are limited and must be allocated efficiently, there is an economic pressure to reduce the costs of health care interventions. This study aims to investigate the cost of testing within a Clinical Chemistry laboratory., Methods: This study was conducted in the Clinical Chemistry laboratory of the University Hospital UZ Brussel, Belgium, in which 156 tests were included and an average cost per test was calculated for the year 2018. Activity-based costing (ABC) was applied, using a top-down perspective. Costs were first allocated to different activity centers and subsequently to different tests. Number of tests, parameters, analyzers and time estimates were used as activity cost drivers., Results: The blood glucose test on the point-of-care testing (POCT) analyzer Accu Chek Inform II had the lowest unit cost (€0.92). The determination of methanol, ethanol and isopropanol on the GC-FID (7820A) is the test with the highest unit cost (€129.42). In terms of average cost per test per activity center, core laboratory (€3.37) scored lowest, followed consecutively by POCT (€3.49), diabetes (€22.09), toxicology (€31.52), metabolic disorder (€41.53) and cystic fibrosis (€86.02). The cost per test was mainly determined by staff (57%), costs of support services (23%) and reagents (14%)., Conclusions: High-volume and automated tests have lower unit costs, as is the case with the core laboratory. ABC provides the ability to identify high average cost tests that can benefit from optimizations, such as focusing on automation or outsourcing low-volume tests that can benefit from economies of scale., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)