Influence of Antimicrobial Stewardship and Molecular Rapid Diagnostic Tests on Antimicrobial Prescribing for Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae in Bloodstream Infection
| Autor: | Christopher A. Jankowski, Yvette S. McCarter, Carmen Isache, Ashlan J Kunz Coyne, Anthony M. Casapao, James Morales |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Physiology Klebsiella pneumoniae medicine.medical_treatment Antibiotics Bacteremia medicine.disease_cause Antimicrobial Stewardship Interquartile range Antimicrobial stewardship Escherichia coli Infections Ecology biology carbapenemase-producing Enterobacterales Middle Aged Antimicrobial QR1-502 Anti-Bacterial Agents Infectious Diseases extended-spectrum beta-lactamase-producing Enterobacterales Female Research Article Microbiology (medical) Adult medicine.drug_class Microbial Sensitivity Tests Microbiology Drug Prescriptions beta-Lactamases Bacterial Proteins molecular rapid diagnostic test Genetics medicine Escherichia coli Humans Aged Retrospective Studies antimicrobial stewardship program General Immunology and Microbiology business.industry Diagnostic Tests Routine Retrospective cohort study Cell Biology biology.organism_classification Klebsiella Infections Beta-lactamase business |
| Zdroj: | Microbiology Spectrum Microbiology Spectrum, Vol 9, Iss 2 (2021) |
| ISSN: | 2165-0497 |
| Popis: | The objective of this study was to evaluate whether the addition of the Verigene BC-GN molecular rapid diagnostic test to standard antimicrobial stewardship practices (mRDT + ASP) decreased the time to optimal and effective antimicrobial therapy for patients with extended-spectrum beta-lactamase (ESBL)- and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae bloodstream infections (BSI) compared to conventional microbiological methods with ASP (CONV + ASP). This was a multicenter, retrospective cohort study evaluating the time to optimal antimicrobial therapy in 5 years of patients with E. coli or K. pneumoniae BSI determined to be ESBL- or carbapenemase-producing by mRDT and/or CONV. Of the 378 patients included (mRDT + ASP, n = 164; CONV + ASP, n = 214), 339 received optimal antimicrobial therapy (mRDT + ASP, n = 161; CONV + ASP, n = 178), and 360 (mRDT + ASP, n = 163; CONV + ASP, n = 197) received effective antimicrobial therapy. The mRDT + ASP demonstrated a statistically significant decrease in the time to optimal antimicrobial therapy (20.5 h [interquartile range (IQR), 17.0 to 42.2 h] versus 50.1 h [IQR, 27.6 to 77.9 h]; P |
| Databáze: | OpenAIRE |
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