Implementation of Rapid Diagnostic Testing without Active Stewardship Team Notification for Gram-Positive Blood Cultures in a Community Teaching Hospital

Antimicrob Agents Chemother. 2018 Oct 24;62(11):e01334-18. doi: 10.1128/AAC.01334-18. Print 2018 Nov.

Abstract

In community hospitals, antimicrobial stewardship team notification of rapid diagnostic testing (RDT) results may not be feasible. A retrospective quasi-experimental study was conducted evaluating 252 adult inpatients with blood cultures positive for Gram-positive cocci in clusters (pre-RDT, n = 143; post-RDT, n = 109). The median time to appropriate therapy was significantly shorter in the post-RDT group (15 versus 0 h, P < 0.001), and the mean length of stay for patients with coagulase-negative staphylococcus was significantly shorter (10.5 versus 7.7 days; P = 0.015).

Keywords: antimicrobial stewardship; bloodstream infections; coagulase-negative staphylococci; rapid diagnostic testing.

MeSH terms

  • Adult
  • Antimicrobial Stewardship / methods
  • Bacteremia / blood
  • Bacteremia / diagnosis
  • Bacteremia / metabolism
  • Bacteremia / microbiology
  • Blood Culture / methods
  • Coagulase / metabolism
  • Female
  • Gram-Positive Bacterial Infections / blood
  • Gram-Positive Bacterial Infections / diagnosis*
  • Gram-Positive Bacterial Infections / metabolism
  • Gram-Positive Bacterial Infections / microbiology
  • Gram-Positive Cocci / isolation & purification*
  • Hospitals, Community / methods
  • Hospitals, Teaching / methods
  • Humans
  • Length of Stay
  • Male
  • Retrospective Studies
  • Staphylococcal Infections / blood
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / metabolism
  • Staphylococcal Infections / microbiology
  • Staphylococcus / isolation & purification

Substances

  • Coagulase