التفاصيل البيبلوغرافية
| العنوان: |
Impact of rapid identification of positive blood cultures using the Verigene system on antibiotic prescriptions: A prospective study of community-onset bacteremia in a tertiary hospital in Japan. |
| المؤلفون: |
Hayakawa, Kayoko, Mezaki, Kazuhisa, Kobayakawa, Masao, Yamamoto, Kei, Mutoh, Yoshikazu, Tsuboi, Motoyuki, Hasimoto, Takehiro, Nagamatsu, Maki, Kutsuna, Satoshi, Takeshita, Nozomi, Katanami, Yuichi, Ishikane, Masahiro, Ohmagari, Norio |
| المصدر: |
PLoS ONE; 7/24/2017, Vol. 12 Issue 7, p1-11, 11p |
| مصطلحات موضوعية: |
DRUG prescribing, ANTIBIOTICS, BACTEREMIA, BLOOD testing, HOSPITALS |
| مصطلحات جغرافية: |
JAPAN |
| مستخلص: |
Background: Rapid identification of positive blood cultures is important for initiation of optimal treatment in septic patients. Effects of automated, microarray-based rapid identification systems on antibiotic prescription against community-onset bacteremia (COB) remain unclear. Methods: We prospectively enrolled 177 patients with 185 COB episodes (occurring within 72 h of admission) over 17 months. Bacteremia episodes due to gram-positive bacteria (GP) and gram-negative bacteria (GN) in the same patient were counted separately. For GP bacteremia, patients with ≥2 sets of positive blood cultures were included. The primary study objective was evaluating the rates of antibiotic prescription changes within 2 days of rapid identification using the Verigene system. Results: Bacteremia due to GN and GP included 144/185 (77.8%) and 41/185 (22.2%) episodes, respectively. Antibiotic prescription changes occurred in 51/185 cases (27.6% [95%CI:21.3–34.6%]) after Verigene analysis and 70/185 cases (37.8% [30.8–45.2%]) after conventional identification and susceptibility testing. Prescription changes after Verigene identification were more frequent in GP (17/41[41.5%]) than in GN (34/144[23.5%]). Among bacteremia due to single pathogen targeted by Verigene test, bacterial identification agreement between the two tests was high (GP: 38/39[97.4%], GN: 116/116[100%]). The Verigene test correctly predicted targeted antimicrobial resistance. The durations between the initiation of incubation and reporting of the results for the Verigene system and conventional test was 28.3 h (IQR: 25.8–43.4 h) and 90.6 h (68.3–118.4 h), respectively. In only four of the seven episodes of COB in which two isolates were identified by conventional tests, the Verigene test correctly identified both organisms. Conclusion: We observed a high rate of antibiotic prescription changes after the Verigene test in a population with COB especially in GP. The Verigene test would be a useful tool in antimicrobial stewardship programs among patients with COB. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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