Optimization of antimicrobial therapy in vancomycin-resistant enterococcal bacteraemia using a rapid detection Gram-positive blood culture assay

2018 ◽  
Vol 99 (2) ◽  
pp. 153-157 ◽  
Author(s):  
R. Nakagawa ◽  
R. Jain ◽  
A.B. Bryan ◽  
J.D. Chan
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
Rapid Detection ◽  
Gram Positive ◽  
Vancomycin Resistant

scholarly journals Impact of a Rapid Microarray-Based Assay for Identification of Positive Blood Cultures for Treatment Optimization for Patients with Streptococcal and Enterococcal Bacteremia

2015 ◽  
Vol 53 (4) ◽  
pp. 1411-1414 ◽  
Author(s):  
Danya G. Roshdy ◽  
Anthony Tran ◽  
Nicholas LeCroy ◽  
Donglin Zeng ◽  
Fang-shu Ou ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Blood Cultures ◽  
Treatment Optimization ◽  
Gram Positive ◽  
Content Type ◽  
Culture Test ◽  
Vancomycin Resistant ◽  
Enterococcal Bacteremia

Implementation of the Verigene Gram-positive blood culture test led to reductions in time to acceptable antibiotic overall (1.9 versus 13.2 h, respectively;P= 0.04) and time to appropriate antibiotic for patients with vancomycin-resistantEnterococcus(4.2 versus 43.7 h;P= 0.006) and viridans groupStreptococcus(0.2 versus 7.1 h;P= 0.02).

scholarly journals 48. Association of Rapid Pathogen Identification and Pharmacist Intervention on Time to Optimal Antimicrobial Therapy for Bloodstream Infections at Two Community Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
Bryant M Froberg ◽  
Nicholas Torney
Keyword(s):  
Blood Culture ◽  
Hospital Mortality ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Pharmacist Intervention ◽  
Pathogen Identification ◽  
Community Hospitals ◽  
Significant Difference

Abstract Background As many as 1 in 3 patients with bloodstream infections at community hospitals receive inappropriate empiric antimicrobial therapy. Studies have shown that the coupling of real-time intervention with rapid pathogen identification improves patient outcomes and decreases health-system costs at large, tertiary academic centers. The aim of this study was to assess if similar outcomes could be obtained with the implementation of real-time pharmacist intervention to rapid pathogen identification at two smaller, rural community hospitals. Methods This was a pre-post implementation study that occurred from September of 2019 to March 2020. This study included patients ≥18 years of age admitted with one positive blood culture. Patients were excluded if they were pregnant, had a polymicrobial blood culture, known culture prior to admission, hospice consulted prior to admission, expired prior to positive blood culture, or transferred to another hospital within 24 hours of a positive blood culture. Endpoints of patients prior to intervention were compared to patients post-implementation. The primary endpoint was time to optimal antimicrobial therapy. Secondary endpoints included time to effective antimicrobial therapy, in-hospital mortality, length of hospital stay, and overall cost of hospitalization. Results Of 212 patients screened, 88 patients were included with 44 patients in each group. Both groups were similar in terms of comorbidities, infection source, and causative microbial. No significant difference was seen in the mean time to optimal antimicrobial therapy (27.3±35.5 hr vs 19.4± 30 hr, p=0.265). Patients in the post-implementation group had a significantly higher mean hospitalization cost ($24,638.87± $11,080.91 vs $32,722.07±$13,076.73, p=0.013). There was no significant difference in time to effective antimicrobial therapy, in-hospital mortality, or length of hospital stay. Conclusion There were no between-group differences in the primary outcome of time to optimal therapy, with a higher mean hospitalization cost after implementation. These results suggest further antimicrobial stewardship interventions are needed, along with larger studies conducted in the community hospital settings. Disclosures All Authors: No reported disclosures

scholarly journals Comparison of Pharmacist-Directed Management of Multiplex PCR Blood Culture Results with Conventional Microbiology Methods on Effective and Optimal Therapy within a Community Hospital

2018 ◽  
Vol 63 (1) ◽  
Author(s):  
Allison M. Porter ◽  
Christopher M. Bland ◽  
Henry N. Young ◽  
David R. Allen ◽  
Sabrina R. Croft ◽  
...  
Keyword(s):  
Blood Culture ◽  
Multiplex Pcr ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
Community Hospital ◽  
Intervention Group ◽  
Standard Of Care ◽  
Pharmacist Intervention ◽  
Coagulase Negative Staphylococcus ◽  
Optimal Therapy

ABSTRACT Multiplex PCR combined with a pharmacist-driven reporting protocol was compared to the standard of care within a community hospital to evaluate initial changes after notification of a positive blood culture. The intervention group demonstrated decreased times to changes in antimicrobial therapy (P = 0.0081), increased changes to optimal antimicrobial therapy (P = 0.013), and decreased vancomycin use for coagulase-negative staphylococcus contaminants (P < 0.01) with multiplex PCR implementation and pharmacist intervention.

VERIGENE GRAM-POSITIVE BLOOD CULTURE TESTING: CLINICAL AND PHARMACOECONOMIC IMPACT

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 835A
Author(s):  
GEORGE UDEANI ◽  
HOA NGO ◽  
UCHE MBADUGHA ◽  
FRANCES CEPEDA ◽  
SALIM SURANI
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Gram Positive

scholarly journals Development of a Prototype Lateral Flow Immunoassay for Rapid Detection of Staphylococcal Protein A in Positive Blood Culture Samples

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 794
Author(s):  
Arpasiri Srisrattakarn ◽  
Patcharaporn Tippayawat ◽  
Aroonwadee Chanawong ◽  
Ratree Tavichakorntrakool ◽  
Jureerut Daduang ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Rapid Detection ◽  
Protein A ◽  
Lateral Flow ◽  
Lateral Flow Immunoassay ◽  
Staphylococcal Protein A ◽  
Highly Sensitive ◽  
Sophisticated Equipment ◽  
Higher Sensitivity

Bloodstream infection (BSI) is a major cause of mortality in hospitalized patients worldwide. Staphylococcus aureus is one of the most common pathogens found in BSI. The conventional workflow is time consuming. Therefore, we developed a lateral flow immunoassay (LFIA) for rapid detection of S. aureus-protein A in positive blood culture samples. A total of 90 clinical isolates including 58 S. aureus and 32 non-S. aureus were spiked in simulated blood samples. The antigens were extracted by a simple boiling method and diluted before being tested using the developed LFIA strips. The results were readable by naked eye within 15 min. The sensitivity of the developed LFIA was 87.9% (51/58) and the specificity was 93.8% (30/32). When bacterial colonies were used in the test, the LFIA provided higher sensitivity and specificity (94.8% and 100%, respectively). The detection limit of the LFIA was 107 CFU/mL. Initial evaluation of the LFIA in 20 positive blood culture bottles from hospitals showed 95% agreement with the routine methods. The LFIA is a rapid, simple and highly sensitive method. No sophisticated equipment is required. It has potential for routine detection particularly in low resource settings, contributing an early diagnosis that facilitates effective treatment and reduces disease progression.

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