The Impact of Integrating Rapid PCR-Based Blood Culture Identification Panel to an Established Antimicrobial Stewardship Program in the United Arab of Emirates

被引:15
作者
Nasef, Rama [1 ]
El Lababidi, Rania [1 ]
Alatoom, Adnan [2 ]
Krishnaprasad, Sumathi [3 ]
Bonilla, Fernanda [4 ]
机构
[1] Cleveland Clin Abu Dhabi, Dept Pharm, Abu Dhabi, U Arab Emirates
[2] Cleveland Clin Abu Dhabi, Cleveland Clin Lab, Abu Dhabi, U Arab Emirates
[3] Cleveland Clin Abu Dhabi, Dept Business Intelligence & Stat Anal, Abu Dhabi, U Arab Emirates
[4] Cleveland Clin Abu Dhabi, Dept Infect Dis, Abu Dhabi, U Arab Emirates
关键词
antimicrobial stewardship; rapid blood culture identification; blood stream infection; BCID; OUTCOMES;
D O I
10.1016/j.ijid.2019.11.028
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Studies have shown improvement in the outcome of blood stream infections (BSI) due to the use of Rapid PCR-Based Blood Culture Identification Panel (BCID) in Antimicrobial stewardship programs (ASP). There is currently no data on the use of BCID with ASP in the United Arab Emirates (UAE). Method: Pre-post quasiexperimental study included hospitalized patients with BSI, their positive blood cultures on BCID were studied in 2 groups: conventional culture with ASP (AS), and BCID with ASP (BCID). The primary outcomes were time to first appropriate antimicrobial therapy, infection related length of stay (LOS), ICU admission, 14 days bacteremia recurrence and in-hospital mortality. Secondary outcomes were 30 days reinfection rate, hospital cost and ASP interventions. Results: Out of total 477 positive blood cultures, 206 (AS and BCID) with real BSI were included. The time needed for organism identification was shorter in the BCID group than in the AS group (1.3 h vs. 51 h; P = 0.0002). BCID had a shorter time to appropriate antimicrobial therapy than AS (17.8 hvs.45 h; P = 0.0004). No statistical difference was observed in mortality rate, 14 days bacteremia recurrence, ICU admission, hospital cost, LOS or ASP interventions. Conclusion: Implementing BCID to ASP significantly decreased the time needed to identify the organism and time to appropriate antimicrobial therapy. Similarly, LOS and hospital cost were reduced, however, the reduction was not statistically significant. (c) 2019 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
引用
收藏
页码:124 / 128
页数:5
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