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Diagn Microbiol Infect Dis ; 101(3): 115474, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34352434

ABSTRACT

Rapid diagnostic testing in microbiology labs shortens the time to identification of bacteria in blood cultures. Cepheid® GeneXpert® MRSA/SA PCR can be used to distinguish MRSA and MSSA from non-Staphylococcus aureus organisms in blood cultures. This study aims to determine if implementation of MRSA/SA PCR for blood culture pathogen identification, plus daily antimicrobial stewardship intervention, can reduce time to appropriate therapy, vancomycin duration, 30 day mortality, and 90 day recurrence in veterans. A total of 113 patients in the pre-implementation cohort and 73 patients in the post-implementation cohort were evaluated. Time to appropriate therapy was decreased from 49.8 (pre-implementation) to 20.6 (post-implementation) hours. There was a numerically shorter median duration of vancomycin therapy in the post-implementation group. There was no difference in 30 day mortality or 90 day recurrence between groups. Use of MRSA/SA PCR can improve antimicrobial use when combined with once-daily antimicrobial stewardship review.


Subject(s)
Bacteremia/diagnosis , Blood Culture/methods , Health Plan Implementation/methods , Staphylococcal Infections/blood , Staphylococcal Infections/diagnosis , Staphylococcus aureus/genetics , Anti-Bacterial Agents/therapeutic use , Antimicrobial Stewardship/methods , Humans , Retrospective Studies , Staphylococcal Infections/drug therapy , Staphylococcal Infections/mortality , Staphylococcus aureus/isolation & purification , Time Factors
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