Implementation of a Rapid Phenotypic Susceptibility Platform for Gram-Negative Bloodstream Infections With Paired Antimicrobial Stewardship Intervention: Is the Juice Worth the Squeeze?
| Autor: | Evan D Robinson, Melinda D. Poulter, Heather L. Cox, Lindsay E Donohue, Zachary S. Elliott, Frankie Brewster, Allison M Stilwell, Megan D Shah, April E Attai, Brandon K. Hill, Amy J. Mathers |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Adult medicine.medical_specialty bloodstream infections medicine.medical_treatment Antimicrobial susceptibility Bacteremia rapid diagnostics Antimicrobial Stewardship Primary outcome Internal medicine Sepsis parasitic diseases Gram-Negative Bacteria Medicine Antimicrobial stewardship Humans Blood culture Gram medicine.diagnostic_test business.industry susceptibility testing Antimicrobial Anti-Bacterial Agents Clinical microbiology Major Articles and Commentaries Infectious Diseases AcademicSubjects/MED00290 Blood Culture Interpersonal psychotherapy business |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background Implementation of the Accelerate PhenoTM Gram-negative platform (RDT) paired with antimicrobial stewardship program (ASP) intervention projects to improve time to institutional-preferred antimicrobial therapy (IPT) for Gram-negative bacilli (GNB) bloodstream infections (BSIs). However, few data describe the impact of discrepant RDT results from standard of care (SOC) methods on antimicrobial prescribing. Methods A single-center, pre-/post-intervention study of consecutive, nonduplicate blood cultures for adult inpatients with GNB BSI following combined RDT + ASP intervention was performed. The primary outcome was time to IPT. An a priori definition of IPT was utilized to limit bias and to allow for an assessment of the impact of discrepant RDT results with the SOC reference standard. Results Five hundred fourteen patients (PRE 264; POST 250) were included. Median time to antimicrobial susceptibility testing (AST) results decreased 29.4 hours (P Implementation of a rapid phenotypic diagnostic test, plus antimicrobial stewardship intervention for Gram-negative bloodstream infections, was associated with significantly faster time to institutional preferred therapy without change in clinical outcomes. Occasional erroneous results contributed to incorrect ASP recommendations. |
| Databáze: | OpenAIRE |
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