Combination of a Rapid Diagnostic Assay and Antimicrobial Stewardship Intervention for Gram-Negative Bacteremia

Julian J. Ventres, Michelle H. Ting, Diane M. Parente, Ralph Rogers, Ashlyn M. Norris, Gregorio Benitez, Fadi Shehadeh, April M. Bobenchik, Eleftherios Mylonakis, Kimberle C. Chapin, Cheston B. Cunha

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Traditional blood cultures for gram-negative bacteremia can take up to 72 hours or more to return results, prolonging the duration of empiric broad-spectrum intravenous antibiotics. The Accelerate Pheno system provides rapid identification and susceptibilities for blood cultures in gram-negative bacteremia. Current data on its clinical utility are mixed overall, so the system requires further research. Methods: A multicenter, retrospective quasi-experimental study was conducted comparing the Accelerate Pheno rapid diagnostic system with antimicrobial stewardship intervention and traditional blood cultures alone. Results: A total of 264 patients with blood cultures with gram-negative bacteria growth were included in the final analysis (102 pre-intervention, 162 post-intervention). The antimicrobial stewardship team made 364 recommendations in 152/162 (93.8%) patients in the post group. Duration of intravenous therapy was shorter (P <. 001) for the post-intervention group (median, 4.0 days) compared with the pre-intervention group (median, 7.5 days). Hospital length of stay was also shorter (P <. 001) for the post-intervention group (median, 5.1 days) compared with the pre-intervention group (median, 7.0 days). Readmission rates within 30 days were reduced (P =. 042) post-intervention (13.0%) compared with pre-intervention (22.6%). In the post-intervention group, a larger proportion of patients were transitioned to oral therapy at any point (126/162, 77.8%) compared with pre-intervention (62/102, 60.8%; P <. 001). Conclusions: These results suggest that the Accelerate Pheno system, with active review and intervention by a multidisciplinary antimicrobial stewardship team, is a useful tool in improving both patient-centric and antimicrobial stewardship outcomes.

Original languageEnglish (US)
Article numberofae477
Pages (from-to)ofae477
JournalOpen Forum Infectious Diseases
Volume11
Issue number9
DOIs
StatePublished - Sep 1 2024

Keywords

  • Accelerate Pheno
  • antimicrobial stewardship
  • duration of therapy
  • gram-negative bacteremia
  • oral antibiotics

ASJC Scopus subject areas

  • Oncology
  • Infectious Diseases

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