ArticlePediatrics2021
Diagnostic Stewardship of Endotracheal Aspirate Cultures in a PICU.
Article in Pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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The trial behind it
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Who cites it
21 citing papers in PubMed.
- Improving the culture surrounding tracheal aspirates in mechanically ventilated children.Journal of clinical microbiology · 2026Article
- Diagnostic Stewardship of Respiratory Cultures Using Clinical Decision Support in the PICU.JAMA network open · 2026Article
- Adherence With Diagnostic Stewardship Guidance and Sociodemographic Characteristics in the PICU.Hospital pediatrics · 2026Article
- Early Antibiotic Discontinuation for Children With a Positive Rapid Respiratory Viral Test Hospitalized for Suspected Bacterial Tracheostomy-Associated Infections.Pediatric pulmonology · 2026Article
- Reductions in ventilator-associated events following implementation of a ventilator-associated pneumonia diagnostic stewardship intervention: A difference-in-difference study.Infection control and hospital epidemiology · 2026Article
- (Un)Sustainable Science: Greening Practices in Research, Clinical Microbiology, and Veterinary Laboratories Locally and Globally.Open forum infectious diseases · 2025Review
- Ancillary Benefit of Microbiology Culture Diagnostic Stewardship: Decreasing Health Care's Climate Impact.Open forum infectious diseases · 2025Article
- Antimicrobial Stewardship Programs in Pediatric Intensive Care Units: A Systematic Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Opportunities for collaboration: the synergy between antimicrobial and diagnostic stewardship in pediatrics.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Review
- The foundation for the microbiology laboratory's essential role in diagnostic stewardship: an ASM Laboratory Practices Subcommittee report.Journal of clinical microbiology · 2024Review
- Improving Antibiotic Use for Ventilator-Associated Pneumonia Through Diagnostic Stewardship: A Proof-of-Concept Mixed Methods Study.Open forum infectious diseases · 2024Article
- Breaking Boundaries in Pneumonia Diagnostics: Transitioning from Tradition to Molecular Frontiers with Multiplex PCR.Diagnostics (Basel, Switzerland) · 2024Review
- Practice Versus Potential: The Impact of the BioFire FilmArray Pneumonia Panel on Antibiotic Use in Children.Journal of the Pediatric Infectious Diseases Society · 2024Article
- A decade of clinical microbiology: top 10 advances in 10 years: what every infection preventionist and antimicrobial steward should know.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- Diagnostic stewardship for blood cultures in the pediatric intensive care unit: lessons in implementation from the BrighT STAR Collaborative.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Healthcare providers consistently overestimate the diagnostic probability of ventilator-associated pneumonia.Infection control and hospital epidemiology · 2023Article
- Impact of Organism Reporting from Endotracheal Aspirate Cultures on Antimicrobial Prescribing Practices in Mechanically Ventilated Pediatric Patients.Journal of clinical microbiology · 2022Article
- Diagnosis, management, and outcomes of pediatric tracheostomy-associated infections: A scoping review.Pediatric pulmonology · 2022Article
- Diagnostic Stewardship in the Pediatric Intensive Care Unit.Infectious disease clinics of North America · 2022Review
- Association of Endotracheal Aspirate Culture Variability and Antibiotic Use in Mechanically Ventilated Pediatric Patients.JAMA network open · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundClinicians commonly obtain endotracheal aspirate cultures (EACs) in the evaluation of suspected ventilator-associated infections. However, bacterial growth in EACs does not distinguish bacterial colonization from infection and may lead to overtreatment with antibiotics. We describe the development and impact of a clinical decision support algorithm to standardize the use of EACs from ventilated PICU patients.
methodsWe monitored EAC use using a statistical process control chart. We compared the rate of EACs using Poisson regression and a quasi-experimental interrupted time series model and assessed clinical outcomes 1 year before and after introduction of the algorithm.
resultsIn the preintervention year, there were 557 EACs over 5092 ventilator days; after introduction of the algorithm, there were 234 EACs over 3654 ventilator days (an incident rate of 10.9 vs 6.5 per 100 ventilator days). There was a 41% decrease in the monthly rate of EACs (incidence rate ratio [IRR]: 0.59; 95% confidence interval [CI] 0.51-0.67;
conclusionsA clinical decision support algorithm standardizing EAC obtainment from ventilated PICU patients was associated with a sustained decline in the rate of EACs, without changes in mortality, readmissions, or length of stay.
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