Randomized Trial Evaluating Clinical Impact of RAPid IDentification and Susceptibility Testing for Gram-negative Bacteremia: RAPIDS-GN

Autor: Nicolynn C. Cole, Peggy C. Kohner, Sukantha Chandrasekaran, Sherry M. Ihde, Annabelle de St Maurice, Jennifer Curello, Michelle Earley, Nipunie S Rajapakse, William Swearingen, Abinash Virk, Katelyn A. Reed, Lauren Komarow, Lisa E. Hines, Robin Patel, Audrey N. Schuetz, Omai B. Garner, Brenda L. Dylla, Meganne Kanatani, Rubi Arias, Sarah B Doernberg, Judith J. Lok, Ritu Banerjee
Rok vydání: 2020
Předmět:
Microbiology (medical)
medicine.medical_specialty
Randomization
medicine.drug_class
gram negative
Clinical Trials and Supportive Activities
Antibiotics
Bacteremia
bloodstream infection
Microbial Sensitivity Tests
Medical and Health Sciences
Microbiology
law.invention
Vaccine Related
Randomized controlled trial
blood cultures
Clinical Research
law
Interquartile range
Sepsis
Internal medicine
Gram-Negative Bacteria
medicine
Gram-negative bacteremia
Humans
Blood culture
Online Only Articles
medicine.diagnostic_test
business.industry
Prevention
Hematology
Biological Sciences
Anti-Bacterial Agents
antibiotic susceptibility testing
Clinical trial
Emerging Infectious Diseases
Good Health and Well Being
Infectious Diseases
Gram staining
Blood Culture
Antimicrobial Resistance
Gram-Negative Bacterial Infections
Infection
business
rapid diagnostic
Zdroj: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol 73, iss 1
Clin Infect Dis
ISSN: 1537-6591
1058-4838
DOI: 10.1093/cid/ciaa528
Popis: Background Rapid blood culture diagnostics are of unclear benefit for patients with gram-negative bacilli (GNB) bloodstream infections (BSIs). We conducted a multicenter, randomized, controlled trial comparing outcomes of patients with GNB BSIs who had blood culture testing with standard-of-care (SOC) culture and antimicrobial susceptibility testing (AST) vs rapid organism identification (ID) and phenotypic AST using the Accelerate Pheno System (RAPID). Methods Patients with positive blood cultures with Gram stains showing GNB were randomized to SOC testing with antimicrobial stewardship (AS) review or RAPID with AS. The primary outcome was time to first antibiotic modification within 72 hours of randomization. Results Of 500 randomized patients, 448 were included (226 SOC, 222 RAPID). Mean (standard deviation) time to results was faster for RAPID than SOC for organism ID (2.7 [1.2] vs 11.7 [10.5] hours; P Conclusions Rapid organism ID and phenotypic AST led to faster changes in antibiotic therapy for gram-negative BSIs. Clinical Trials Registration NCT03218397.
Databáze: OpenAIRE
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