Impact of an Antimicrobial Stewardship Program-bundled initiative utilizing Accelerate Pheno™ system in the management of patients with aerobic Gram-negative bacilli bacteremia
| Autor: | Nitin Bhanot, Karen Kasarda, Tamara L. Trienski, Dustin R Carr, Christian Y Cho, Thomas L. Walsh, Nicholas Cheronis, Kelly Stefano, Catharine Hand, Matthew A. Moffa, Tricia Taylor, Carley Buchanan, Derek N Bremmer, Briana E. DiSilvio, Nathan R. Shively |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Definitive Therapy 030106 microbiology Accelerate Pheno™ Antimicrobial susceptibility Bloodstream infection Antimicrobial stewardship law.invention 03 medical and health sciences 0302 clinical medicine Antibiotic resistance law Internal medicine Antibiotic therapy medicine 030212 general & internal medicine Rapid diagnostic testing Original Paper business.industry General Medicine Gram negative bacilli medicine.disease Infectious Diseases Gram staining Bacteremia Gram-negative bacteremia business |
| Zdroj: | Infection |
| ISSN: | 1439-0973 0300-8126 |
| Popis: | Purpose Gram-negative bacteria (GNB) are a leading cause of bloodstream infections (BSI) and management is complicated by antibiotic resistance. The Accelerate Pheno™ system (ACC) can provide rapid organism identification and antimicrobial susceptibility testing (AST). Methods A retrospective, pre-intervention/post-intervention study was conducted to compare management of non-critically ill patients with GNB BSI before and after implementation of a bundled initiative. This bundled initiative included dissemination of a clinical decision algorithm, ACC testing on all GNB isolated from blood cultures, real-time communication of results to the Antimicrobial Stewardship Program (ASP), and prospective audit with feedback by the ASP. The pre-intervention period was January 2018 through December 2018, and the post-intervention period was May 2019 through February 2020. Results Seventy-seven and 129 patients were included in the pre-intervention and post-intervention cohorts, respectively. When compared with the pre-intervention group, the time from Gram stain to AST decreased from 46.1 to 6.9 h (p p p p = 0.047) without an increase in 30-day readmissions (22.1% vs 14%; p = 0.13). Conclusion Implementation of an ASP-bundled approach incorporating the ACC aimed at optimizing antibiotic therapy in the management GNB BSI in non-critically ill patients led to reduced TTDT, shorter duration of antibiotic therapy, and shorter hospital length of stay without adversely affecting readmission rates. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink