Sustained impact of a rapid microarray-based assay with antimicrobial stewardship interventions on optimizing therapy in patients with Gram-positive bacteraemia

Autor: Karen C. Carroll, Stephanie Shulder, Ruibin Wang, Edina Avdic, Sara E. Cosgrove, Pranita D. Tamma, David X. Li
Rok vydání: 2017
Předmět:
Adult
Male
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
medicine.drug_class
Gram-positive bacteria
030106 microbiology
Antibiotics
Psychological intervention
Bacteremia
law.invention
Antimicrobial Stewardship
03 medical and health sciences
law
Internal medicine
medicine
Humans
Antimicrobial stewardship
Pharmacology (medical)
Blood culture
Hospital Mortality
Intensive care medicine
Gram-Positive Bacterial Infections
Aged
Oligonucleotide Array Sequence Analysis
Retrospective Studies
Pharmacology
biology
medicine.diagnostic_test
business.industry
Middle Aged
biology.organism_classification
medicine.disease
Anti-Bacterial Agents
Discontinuation
Gram-Positive Cocci
Treatment Outcome
Infectious Diseases
Gram staining
Molecular Diagnostic Techniques
Blood Culture
Female
business
Zdroj: Journal of Antimicrobial Chemotherapy. 72:3191-3198
ISSN: 1460-2091
0305-7453
DOI: 10.1093/jac/dkx267
Popis: Objectives To compare antibiotic optimization and outcomes of patients before implementation of the Verigene Gram-Positive Blood Culture (Verigene BC-GP) nucleic acid microarray assay to after implementation with antimicrobial stewardship (AS) interventions and after discontinuation of AS interventions. Methods A retrospective pre-post-post quasi-experimental study was conducted to compare the three periods. AS interventions consisted of real-time guidance to clinicians on antibiotic selection. The primary outcome was median time from Gram stain to optimal therapy. Secondary outcomes included median time to effective therapy, median duration of therapy for contaminant organisms, median length of stay after blood cultures were collected, and all-cause in-hospital mortality. Results Out of a total of 923 patients, 390 (125 baseline, 134 intervention, 131 post-intervention) who were not on optimal therapy at the time of Gram stain or had contaminated blood cultures were assessed. Compared with baseline, only the median time to optimal therapy for MSSA bacteraemia was reduced in both the intervention and post-intervention periods (17 versus 17 versus 50 h; P
Databáze: OpenAIRE
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