Universität zu Köln

Ehren, Kathrin, Meissner, Arne ORCID: 0000-0002-8506-1624, Jazmati, Nathalie, Wille, Julia, Jung, Norma, Vehreschild, Joerg Janne, Hellmich, Martin and Seifert, Harald (2020). Clinical Impact of Rapid Species Identification From Positive Blood Cultures With Same-day Phenotypic Antimicrobial Susceptibility Testing on the Management and Outcome of Bloodstream Infections. Clin. Infect. Dis., 70 (7). S. 1285 - 1294. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

Full text not available from this repository.

Abstract

Background. Timely availability of microbiological results from positive blood cultures is essential to enable early pathogen-directed therapy. The Accelerate Pheno system (ADX) is a novel technology using fluorescence in situ hybridization for rapid species identification (ID) and morphokinetic bacterial analysis for phenotypic antimicrobial susceptibility testing (AST), with promising results. Yet the impact of this technology on clinical management and patient outcome remains unclear. Methods. We conducted a quasiexperimental before-and-after observational study and analyzed 3 groups with different diagnostic and therapeutic pathways following recent integration of ADX: conventional microbiological diagnostics with and without antimicrobial stewardship program (ASP) intervention, and rapid diagnostics (ADX in addition to conventional standard) with ASP intervention. Primary endpoints were time to adequate, to optimal and to step-down antimicrobial therapy. Secondary endpoints were antimicrobial consumption, in-hospital mortality, length of stay (LOS), and the incidence of Clostridioides difficile infection (CDI). Results. Two hundred four patients (conventional diagnostics, n = 64; conventional diagnostics + ASP, n = 68; rapid diagnostics + ASP; n = 72) were evaluated. The use of ADX significantly decreased time from Gram stain to ID (median, 23 vs 2.2 hours, P <.001) and AST (median, 23 vs 7.4 hours, P <.001), from Gram stain to optimal therapy (median, 11 vs 7 hours, P =.024) and to step-down antimicrobial therapy (median, 27.8 vs 12 hours, P =.019). However, groups did not differ in antimicrobial consumption, duration of antimicrobial therapy, mortality, LOS, or incidence of CDI. Conclusions. Use of ADX significantly reduced time to ID and AST as well as time to optimal antimicrobial therapy but did not affect antimicrobial consumption and clinical outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ehren, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Meissner, Arne UNSPECIFIED orcid.org/0000-0002-8506-1624 UNSPECIFIED Jazmati, Nathalie UNSPECIFIED UNSPECIFIED UNSPECIFIED Wille, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Jung, Norma UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Joerg Janne UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-338358
DOI:	10.1093/cid/ciz406
Journal or Publication Title:	Clin. Infect. Dis.
Volume:	70
Number:	7
Page Range:	S. 1285 - 1294
Date:	2020
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1537-6591
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language THERAPY; BACTEREMIA; SEPSIS; TIME; GUIDELINES Multiple languages Immunology; Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33835