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首页> 外文期刊>The journal of applied laboratory medicine. >Impact of Rapid Susceptibility Testing System on the Management of Gram-Negative Bacteremia in a Network of Community Hospitals
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Impact of Rapid Susceptibility Testing System on the Management of Gram-Negative Bacteremia in a Network of Community Hospitals

机译：快速磁化率测试系统的影响管理的革兰氏阴性菌血症网络社区医院

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Background: Rapid initiation of optimal antimicrobial therapy is crucial for the management of Gram-negative (GN) bacteremia. We aimed to evaluate the impact of Accelerate Pheno (TM) (AxDx) system on change in therapy and length of stay among patients with GN bacteremia. Methods: We conducted a retrospective cohort study of adult patients hospitalized who had at least 1 blood culture with presence of Enterobacterales. We compared clinical outcomes among patients who had their blood cultures processed through standard methods alone vs AxDx. Results: We identified 255 bacteremia episodes among 243 unique patients. In the AxDx group, 31.1% of patients had deescalation of antibiotics within 48 h from blood culture collection compared to 20.0% of patients in the control group (P=0.09). We found no impact of AxDx on the odds of deescalation at 48h from blood culture collection [odds ratio (OR) 1.80 (95% CI 0.91-3.56), P=0.09] or Gram stain report [OR 1.61 (95% CI 0.86-3.01), P= 0.14]. Escalation in therapy at 48h from blood culture collection occurred in 16.8% and 16.9% of patients in the AxDx and control groups, respectively (P=0.99). There was no impact on the odds of escalation at 48 h from blood culture collection [OR 0.99 (95% CI 0.47-2.11), P=0.99] or Gram stain report [OR 1.26 (95% CI 0.57-2.80), P= 0.57]. No differences were seen in length of stay and mortality between the 2 groups. Conclusions: The impact of rapid identification and susceptibility technologies may differ according to the setting in which they are implemented.
机译：背景:最优的快速启动抗菌治疗是至关重要的革兰氏阴性菌血症(GN)的管理。旨在评估把加速的影响(TM) (AxDx)系统在治疗和改变的长度保持在GN患者菌血症。方法:我们进行了一项回顾性队列研究成人患者曾在住院1血培养的存在Enterobacterales。在患者血培养仅通过标准方法vs AxDx处理。结果:我们发现255菌血症发作在243个独特的病人。31.1%的病人有deescalation抗生素血培养48 h内集合而只有20.0%的患者在控制组(P = 0.09)。的几率deescalation从血培养48 h集合(比值比(或)1.80(95%可信区间0.91 - -3.56), P = 0.09)或革兰氏染色剂报告(或1.61(95% CI 0.86 - -3.01), P = 0.14)。从血培养收集治疗48 h发生在患者的16.8%和16.9%分别AxDx和对照组(P = 0.99)。没有影响升级的可能性从血培养48 h集合(或0.99 (95%可信区间0.47 - -2.11),P = 0.99)和革兰氏染色剂(或报告1.26 (95% CI 0.57 - -2.80), P = 0.57)。在停留时间和死亡率之间的吗2组。识别和敏技术可以根据设置的不同吗实现。

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