Evidence map›Paper›PMID 28534213›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2017

Impact of antimicrobial stewardship and rapid microarray testing on patients with Gram-negative bacteremia.

K R Rivard, V Athans, S W Lam, S M Gordon, G W Procop, S S Richter, E Neuner

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Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  19. New Approaches to Manage Infections in Transplant Recipients: Report From the 2023 GTI (Infection and Transplantation Group) Annual Meeting.Transplant international : official journal of the European Society for Organ Transplantation · 2023
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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

7 authors.

K R RivardDepartment of Pharmacy, Cleveland Clinic, 9500 Euclid Ave/Hb-105, Cleveland, OH, 44195, USA. rivardk@ccf.org.
V AthansDepartment of Pharmacy, Cleveland Clinic, 9500 Euclid Ave/Hb-105, Cleveland, OH, 44195, USA.
S W LamDepartment of Pharmacy, Cleveland Clinic, 9500 Euclid Ave/Hb-105, Cleveland, OH, 44195, USA.
S M GordonDepartment of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA.
G W ProcopDepartment of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA.
S S RichterDepartment of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA.
E NeunerDepartment of Pharmacy, Cleveland Clinic, 9500 Euclid Ave/Hb-105, Cleveland, OH, 44195, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A rapid microarray assay, Nanosphere Verigene® Gram-negative blood culture test (BC-GN), detects four Gram-negative species, four Gram-negative genera, and six resistance genes directly from positive blood culture samples, shortening the time from Gram stain to pathogen and resistance-gene identification. The purpose of this study was to determine the impact of the BC-GN paired with an antimicrobial stewardship intervention on antimicrobial and clinical outcomes. Patients with Gram-negative bacteremia were compared before (n = 456) and after (n = 421) BC-GN implementation. The primary objective was to compare time from Gram stain to antimicrobial switch pre- and post-implementation. Time from Gram stain to effective treatment, in-hospital mortality, and hospital length of stay were also compared. The number and type of antimicrobial switches were similar between groups. Median (IQR) time from Gram stain to antimicrobial switch was significantly decreased in the post group, 28.6 (8.6-56.9) h vs 44.1 (18.9-64.6) h, p = 0.004. In patients on ineffective antimicrobial therapy at the time of result, median time to effective therapy was lower in the post group, 8.8 (5.5-18.4) h vs 24.5 (4.9-44.3) h, p = 0.034. Median (IQR) hospital length of stay was also decreased in the post group, 7 (5-15) days vs 9 (4.5-21) days, p = 0.001. The rate of in-hospital mortality was similar between groups, 11.6% (pre) vs 11.4% (post), p = 0.87. Rapid microarray testing on blood cultures combined with active antimicrobial stewardship intervention was associated with decreased time to antimicrobial switch, time to effective therapy, and hospital length of stay.

Indexed as

Antimicrobial StewardshipAgedBacteremiaBloodFemaleGram-Negative BacteriaGram-Negative Bacterial InfectionsHumansLength of StayMaleMicroarray AnalysisMiddle AgedMolecular Diagnostic TechniquesRetrospective StudiesSurvival AnalysisAntimicrobial stewardshipBlood culturesGram-negative bacteremiaRapid diagnostic tests

Identifiers

PMID28534213

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Registered trials

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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.