Evidence map›Paper›PMID 27832502›Full record

ArticleInfectious diseases and therapy2016

A Retrospective Study of the Impact of Rapid Diagnostic Testing on Time to Pathogen Identification and Antibiotic Use for Children with Positive Blood Cultures.

Angela Fimbres Veesenmeyer, Jared A Olson, Adam L Hersh, Chris Stockmann, Kent Korgenski, Emily A Thorell, Andrew T Pavia, Anne J Blaschke

Abstract read
In one paragraph

Article in Infectious diseases and therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Expanding Existing Antimicrobial Stewardship Programs in Pediatrics: What Comes Next.Journal of the Pediatric Infectious Diseases Society · 2018
    Review
  5. Educational Case:Academic pathology
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Angela Fimbres VeesenmeyerDepartment of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Jared A OlsonPrimary Children's Hospital, Salt Lake City, UT, USA.
Adam L HershDepartment of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Chris StockmannDepartment of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Kent KorgenskiPediatric Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA.
Emily A ThorellDepartment of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Andrew T PaviaDepartment of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Anne J BlaschkeDepartment of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA. anne.blaschke@hsc.utah.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRapid identification of bloodstream pathogens provides crucial information that can improve the choice of antimicrobial therapy for children. Previous impact studies have primarily focused on adults. Our objective was to evaluate the impact of rapid testing in a children's hospital on time to organism identification and antibiotic use in the setting of an established antimicrobial stewardship program.

methodsWe conducted a retrospective study over three consecutive time periods (spanning January 2013-August 2015) as our hospital sequentially introduced two rapid testing methods for positive blood cultures. An antimicrobial stewardship program was active throughout the study. In the baseline period, no rapid diagnostic methods were routinely utilized. In the second period (PNAFISH), a fluorescent in situ hybridization test was implemented for gram-positive organisms and in the third a rapid multiplex PCR (rmPCR) test was employed. For children with positive blood cultures, time to organism identification use and duration of select antimicrobial therapies were compared between periods.

resultsPositive blood cultures were analyzed. Median overall time to organism identification was 23, 11, and 0 h in the baseline, PNAFISH, and rmPCR periods, respectively (p < 0.001 for both PNAFISH and rmPCR vs. baseline). For gram-negative organisms, only rmPCR performed significantly faster than baseline (p < 0.001). The duration of vancomycin use for coagulase-negative staphylococci was shorter in both the PNAFISH and rmPCR periods (mean 31 h in the baseline period, 12 and 14 h in the PNAFISH and rmPCR periods, respectively). For MSSA bacteremia, use of vancomycin was significantly decreased only in the rmPCR period (32% of patients vs. 64 and 72% in the baseline and PNAFISH periods; mean duration of 9 h vs. 30 and 26 h). There was no difference in use or duration of broad-spectrum gram-negative therapy across the three time periods.

conclusionRapid diagnostic testing for children with positive blood cultures results in faster time to identification and can influence antibiotic prescribing in the setting of active antimicrobial stewardship particularly for gram-positive pathogens.

fundingMerck.

Indexed as

Antibiotic useAntimicrobial stewardshipBloodstream infectionMolecular testingRapid diagnostic methods

Identifiers

PMID27832502
PMCPMC5125139

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.