TY - JOUR
T1 - Clinical impact of implementation of rapid diagnostic testing of blood cultures with Staphylococcus aureus on patient outcomes
AU - Gritte, Anndee S.
AU - Morneau, Kathleen M.
AU - Frei, Chris
AU - Cadena-Zuluaga, Jose A.
AU - Walter, Elizabeth A.
AU - Hopkins, Teri L.
N1 - Publisher Copyright:
© 2021
PY - 2021/11
Y1 - 2021/11
N2 - 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.
AB - 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.
KW - Bacteremia
KW - Blood culture
KW - Bloodstream infection
KW - Cepheid®
KW - Rapid Diagnostic Testing (RDT)
KW - Staphylococcus aureus
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UR - http://www.scopus.com/inward/citedby.url?scp=85111587039&partnerID=8YFLogxK
U2 - 10.1016/j.diagmicrobio.2021.115474
DO - 10.1016/j.diagmicrobio.2021.115474
M3 - Article
C2 - 34352434
AN - SCOPUS:85111587039
SN - 0732-8893
VL - 101
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 3
M1 - 115474
ER -