Antibiotic Utilization Improvement with the Nanosphere Verigene Gram-Positive Blood Culture Assay

Beal, Stacy G.; Thomas, Cody; Dhiman, Neelam; Nguyen, Daniel P.; Qin, Haili; Hawkins, Jennifer M; Dekmezian, Mhair; Benavides, Raul

doi:10.1080/08998280.2015.11929214

Cited by 25 publications

(15 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While there were no differences in overall mortality rates or hospital lengths of stay, a reduction in the time to deescalation of antimicrobial therapy compared to conventional methods (i.e., culture with MALDI-TOF MS identification) was observed for the (18) reported reductions in 30-day mortality rates (3 versus 13%; P ϭ 0.019), costs associated with antimicrobial treatment, and time to optimization of the antimicrobial regimen in hospitalized patients (control group, n ϭ 147; intervention group, n ϭ 88) with bacteremia after the implementation of the Verigene BC-GP and BC-GN assays compared to conventional identification (MicroScan WalkAway-96; Beckman Coulter, Inc.). Beal et al reported increased deescalation of empirical antibiotics and a reduction in the time to optimal antibiotics for patients with methicillin-susceptible S. aureus and vancomycin-resistant enterococcal bacteremia after the implementation of the Verigene BC-GP assay paired with a defined result-reporting algorithm using electronic communications compared to a preintervention group for which traditional phenotypic methods and the Vitek 2 system (bioMérieux) were utilized for identification and antimicrobial susceptibility testing (19).…”

Section: Clinical and Economic Impactsmentioning

confidence: 99%

Syndromic Panel-Based Testing in Clinical Microbiology

et al. 2018

View full text Add to dashboard Cite

The recent development of commercial panel-based molecular diagnostics for the rapid detection of pathogens in positive blood culture bottles, respiratory specimens, stool, and cerebrospinal fluid has resulted in a paradigm shift in clinical microbiology and clinical practice. This review focuses on U.S. Food and Drug Administration (FDA)-approved/cleared multiplex molecular panels with more than five targets designed to assist in the diagnosis of bloodstream, respiratory tract, gastrointestinal, or central nervous system infections. While these panel-based assays have the clear advantages of a rapid turnaround time and the detection of a large number of microorganisms and promise to improve health care, they present certain challenges, including cost and the definition of ideal test utilization strategies (i.e., optimal ordering) and test interpretation.

show abstract

Section: Clinical and Economic Impactsmentioning

confidence: 99%

Syndromic Panel-Based Testing in Clinical Microbiology

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Th e primary objective was to evaluate the clinical uptake and utilization of the BC-GN results by measuring the reduction in time from positive blood culture to the deescalation of empiric therapy and the switch to the fi rst dose of appropriate antibiotics per the resulting algorithm. As previously published, an algorithm designed using electronic communications and minimum pharmacist intervention was used (7,8). We also determined if there were any site-specifi c diff erences in the uptake of stewardship recommendations within the network.…”

mentioning

confidence: 99%

Clinical Uptake of Antimicrobial Stewardship Recommendations Following Nanosphere Verigene Blood Culture Gram-Negative Reporting

Belknap¹,

Grosser²,

Hale³

et al. 2017

Baylor University Medical Center Proceedings

Self Cite

View full text Add to dashboard Cite

“…Th e high rate of correlation between rapid methods and culture validates the usefulness of the BC-GP molecular assay in a clinical laboratory workfl ow for providing proper and rapid patient management. Th e impact on clinical outcomes from this study is addressed in a separate communication (20). Briefl y, we demonstrated a signifi cant decrease (P < 0.05) in time from collection to the fi rst dose of appropriate antibiotics for patients with methicillin-sensitive Staphylococcus aureus and vancomycin-resistant enterococci.…”

Section: Discussionmentioning

confidence: 63%

“…Briefl y, we demonstrated a signifi cant decrease (P < 0.05) in time from collection to the fi rst dose of appropriate antibiotics for patients with methicillin-sensitive Staphylococcus aureus and vancomycin-resistant enterococci. Additionally, the percent of patients on empiric therapy who were placed on appropriate antibiotics after the Gram stain result was available increased from 64% pre-BC-GP to 80% post-BC-GP (20).…”

Section: Discussionmentioning

confidence: 99%

The Success Model for Laboratory Performance and Execution of Rapid Molecular Diagnostics in Patients with Sepsis

Dekmezian

Beal

Damashek

et al. 2015

Baylor University Medical Center Proceedings

Self Cite

View full text Add to dashboard Cite

Successful performance and execution of rapid diagnostics in a clinical laboratory hinges heavily on careful validation, accurate and timely communication of results, and real-time quality monitoring. Laboratories must develop strategies to integrate diagnostics with stewardship and evidence-based clinical practice guidelines. We present a collaborative SUCCESS model for execution and monitoring of rapid sepsis diagnostics to facilitate timely treatment. Six months after execution of the Verigene Gram-Positive Blood Culture (BC-GP) and the AdvanDx PNA-FISH assays, data were collected on 579 and 28 episodes of bacteremia and fungemia, respectively. Clinical testing was executed using a SUCCESS model comprising the following components: stewardship, utilization of resources, core strategies, concierge services, education, support, and surveillance. Stewardship needs were identified by evaluating the specialty services benefiting from new testing. Utilization of resources was optimized by reviewing current treatment strategies and antibiogram and formulary options. Core strategies consisted of input from infectious disease leadership, pharmacy, and laboratory staff. Concierge services included automated Micro-eUpdate and physician-friendly actionable reports. Education modules were user-specific, and support was provided through a dedicated 24/7 microbiology hotline. Surveillance was performed by daily audit by the director. Using the SUCCESS model, the turnaround time for the detailed report with actionable guidelines to the physician was ~3 hours from the time of culture positivity. The overall correlation between rapid methods and culture was 94% (546/579). Discrepant results were predominantly contaminants such as a coagulase-negative staphylococci or viridans streptococci in mixed cultures. SUCCESS is a cost-effective and easily adaptable model for clinical laboratories with limited stewardship resources.

show abstract

Antibiotic Utilization Improvement with the Nanosphere Verigene Gram-Positive Blood Culture Assay

Cited by 25 publications

References 11 publications

Syndromic Panel-Based Testing in Clinical Microbiology

Syndromic Panel-Based Testing in Clinical Microbiology

Clinical Uptake of Antimicrobial Stewardship Recommendations Following Nanosphere Verigene Blood Culture Gram-Negative Reporting

The Success Model for Laboratory Performance and Execution of Rapid Molecular Diagnostics in Patients with Sepsis

Contact Info

Product

Resources

About