...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Canadian journal of hospital pharmacy. >Identification of Staphylococci by Polymerase Chain Reaction Directly from a Positive Blood Culture and Effect on Patient Care
【24h】

Identification of Staphylococci by Polymerase Chain Reaction Directly from a Positive Blood Culture and Effect on Patient Care

机译：直接从阳性血液培养和对患者护理作用的鉴定用聚合酶链反应的鉴定

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: As one of the most common bloodstream infections worldwide, Staphylococcus aureus bacteremia places a major burden on health care. Implementation of a rapid, genetic-based diagnostic test may have important implications in the clinical management of patients with S. aureus bacteremia. Objectives: The primary objective was to assess concordance between testing based on polymerase chain reaction (PCR) and the current gold standard, culture and sensitivity testing; the secondary objective was to assess the impact of this technology on patient care. Methods: A pre-post intervention retrospective chart review was used to document the hospital course of patients with a diagnosis of S. aureus bacteremia before and after implementation of the PCR-based diagnostic system. Laboratory results from all patient samples subjected to PCR-based analysis following implementation of this system were compared with culture and sensitivity data for the same samples to determine accuracy of the new system. In addition, time to optimal therapy for each patient was calculated as the interval between the initiation of empiric and terminal therapies. The appropriateness of antimicrobial treatment was characterized as guideline-concordant, nonconcordant with the guidelines, or nonconcordant yet still clinically appropriate. Results: In total, 98 and 99 patients met the inclusion criteria before and after implementation of the PCR-based diagnostic system, respectively. PCR-based results displayed 99.8% concordance (440/441 total samples) with results from culture and sensitivity testing. The time to optimal therapy was significantly shorter after implementation, by a mean of 22.8 h (p < 0.001). Overall, 97% of empiric and 99% of terminal antimicrobial regimens were either guideline-concordant or clinically appropriate for treatment of S. aureus bacteremia; 3% of empiric and 1% of terminal antimicrobial regimens were nonconcordant with clinical guidelines without any explanation based on other clinical considerations. Conclusions: The study findings support the utility of using a direct-from-positive-blood-culture PCR-based diagnostic tool as the primary method of identifying S. aureus bacteremia in patients, as well as the acceptance of and acting upon the new assay’s results by our local clinicians. PCR-based assays can help reduce the time to optimal terminal therapy for patients with bacteremia.
机译：背景：作为全球最常见的血液感染之一，金黄色葡萄球菌菌血症给医疗保健带来了重大负担。实施快速、基于基因的诊断检测可能对金黄色葡萄球菌菌血症患者的临床管理具有重要意义。目的：主要目的是评估基于聚合酶链反应（PCR）的检测与当前金标准、培养和敏感性检测之间的一致性；第二个目标是评估这项技术对患者护理的影响。方法：采用干预前后回顾性图表回顾，记录实施基于PCR的诊断系统前后诊断为金黄色葡萄球菌菌血症患者的住院过程。在实施该系统后，所有接受PCR分析的患者样本的实验室结果与相同样本的培养和敏感性数据进行比较，以确定新系统的准确性。此外，每名患者的最佳治疗时间计算为开始经验性治疗和终止治疗之间的间隔。抗菌治疗的适宜性表现为指南一致、与指南不一致或不一致但仍适用于临床。结果：在实施基于PCR的诊断系统之前和之后，分别有98名和99名患者符合纳入标准。基于PCR的结果显示，与培养和敏感性测试结果的一致性为99.8%（440/441总样本）。实施后达到最佳治疗的时间显著缩短，平均缩短22.8小时（p<0.001）。总的来说，97%的经验性和99%的终末抗菌方案要么符合指南，要么临床上适合治疗金黄色葡萄球菌菌血症；3%的经验性和1%的终末抗菌方案与临床指南不一致，没有基于其他临床考虑的任何解释。结论：研究结果支持使用直接来自阳性血培养PCR的诊断工具作为鉴别患者金黄色葡萄球菌菌血症的主要方法，以及本地临床医生对新检测结果的接受和作用。基于PCR的检测有助于缩短菌血症患者的最佳终末治疗时间。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号