The impact of implementation of rapid blood culture identification panels on antimicrobial optimization: a retrospective cohort study.
Antimicrob Steward Healthc Epidemiol
; 4(1): e44, 2024.
Article
em En
| MEDLINE
| ID: mdl-38628375
ABSTRACT
Objective:
Determine the impact of limited implementation of a rapid blood culture identification (BCID) panel.Design:
Retrospective cohort study.Methods:
From February to April 2022, positive blood cultures identified via e-Plex BCID (Roche, Carlsbad, CA) were compared to those identified using standard microbial identification techniques. The primary outcomes assessed were time to optimal therapy, time to de-escalation of anti-MRSA (methicillin-resistant Staphylococcus aureus) agents, and time to de-escalation of anti-pseudomonal agents. Additional analysis investigated the impact of the availability of antimicrobial stewardship program support. This study was conducted at Grady Health System, a large metropolitan safety-net hospital in the southeastern United States.Results:
A total of 253 blood cultures were included in this study (153 BCID and 100 standard). Blood culture identification use was associated with a reduction in median time to optimal antimicrobial therapy (43.4 vs 72.1 h, P < .001) and median time to de-escalation of anti-MRSA agents (27.7 vs 46.7 h, P = .006), and a trend towards reduction of median time to de-escalation of anti-pseudomonal agents (38.8 vs 54.8 h, P = .07). These reductions persisted when controlling for patient age, sex, intensive care unit status, Charlson Comorbidity Index, and antimicrobial stewardship program availability.Conclusions:
Despite restricted use and lack of 24/7 antimicrobial stewardship program availability, BCID panel utilization was associated with earlier initiation of optimal therapy and pathogen identification with subsequent de-escalation of broad-spectrum antimicrobials, as compared to standard antimicrobial techniques. This suggests the potential for benefit from adopting novel diagnostic technologies outside of idealized fully-resourced settings.
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Base de dados:
MEDLINE
Idioma:
En
Revista:
Antimicrob Steward Healthc Epidemiol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos