Collaboration between an antimicrobial stewardship team and the microbiology laboratory can shorten time to directed antibiotic therapy for methicillin-susceptible staphylococcal bacteremia and to discontinuation of antibiotics for coagulase-negative staphylococcal contaminants.
Publication/Presentation Date
11-1-2018
Abstract
BACKGROUND: Rapid identification of Gram-positive cocci in clusters (GPCC) in positive blood cultures (pBC) may limit exposure to unnecessary or inappropriate antibiotics.
METHODS: Inpatients with pBC showing GPCC between October 2013 and December 2017 were included. In the baseline period (BL), final ID and susceptibility results were reported in the electronic medical record (EMR) within 48 h of telephoned Gram stain report. The laboratory introduced rapid phenotypic identification and direct susceptibility testing (INT1), later replaced by PCR (INT2). In the last Intervention (INT3), Antimicrobial Stewardship Response Team (ASRT) contacted providers with PCR results and recommendations.
RESULTS: Time to directed therapy (TDT) for MSSA and coagulase-negative Staphylococci (CoNS) decreased from BL to INT3 (48.5-17.9 h, 50.3-16.4 h, respectively). Time to ID from BL to INT3 for MSSA and CoNS also decreased (23.2-1.9 h, 44.7-2.8, respectively).
CONCLUSIONS: TDT can be improved by modification of reporting methods with utilization of an ASRT.
Volume
92
Issue
3
First Page
214
Last Page
219
ISSN
1879-0070
Published In/Presented At
Bhowmick, T., Kirn, T. J., Hetherington, F., Takavarasha, S., Sandhu, S. S., Gandhi, S., Narayanan, N., & Weinstein, M. P. (2018). Collaboration between an antimicrobial stewardship team and the microbiology laboratory can shorten time to directed antibiotic therapy for methicillin-susceptible staphylococcal bacteremia and to discontinuation of antibiotics for coagulase-negative staphylococcal contaminants. Diagnostic microbiology and infectious disease, 92(3), 214–219. https://doi.org/10.1016/j.diagmicrobio.2018.05.020
Disciplines
Medicine and Health Sciences
PubMedID
29983288
Department(s)
Department of Medicine
Document Type
Article