The Utility of Rapid Microbiological and Molecular Techniques in Optimizing Antimicrobial Therapy

Eiland, Edward H.; Beyda, Nicholas D.; Han, Jian; Lindgren, William; Ward, R; English, Thomas M.; Hassoun, Ali; Hathcock, Kathi

doi:10.3814/2010/395215

Cited by 5 publications

(6 citation statements)

References 18 publications

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“…Study performed by Eiland III et al showed similar results. 22 For the prevention of development of resistance antimicrobial stewardship programme should be initiated in the hospital and guidelines should be formulated for effective use of antimicrobials at hospital. Antimicrobial stewardship programme have been shown to reduce inappropriate antimicrobial use, with resulting reductions in antimicrobial resistance, and also lead to more appropriate antimicrobial therapy for infections where therapy is required, with improved clinical outcomes for patients.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome

Damor

Kubavat

2019

Int J Basic Clin Pharmacol

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Background: Antimicrobials are the greatest discovery of the twentieth century. To limit the emergence and spread of resistance, antibiotic therapy should be adjusted according to the results of microbiological culture. Klebsiella isolates causes various types of infections and the incidence of antibiotic resistance is also high in Klebsiella infections. So, Authors plan this study to analyze how the results of microbiological cultures influence the antibiotic use in the treatment of Klebsiella infections.Methods: It is a record based observational prospective study which assessed the impact of Klebsiella positive culture results on antibiotic prescribing pattern and its impact on clinical outcome. Patients with empirical antibiotic therapy and Klebsiella positive were included and patients with inadequate data were excluded in this study and the data were recorded. Recorded data were entered and analyzed in Microsoft Office Excel-2013. Unpaired student t-test was used to compare the mean duration of hospital stay using Past software (version 3.20).Results: There were total 400 patients in our study. Amikacin was the most common drug (n=202) used as empirical therapy. Empirical antibiotic therapy was changed in 161(40.25%) patients. Meropenem was the most commonly used definitive drug. Mean duration of hospital stay is less in empirical sensitive antibiotic therapy as compared to empirical resistance antibiotic therapy having p value <0.0001 which shows significant difference between two groups showing better clinical outcome.Conclusion: Initial empirical therapy with broad-spectrum antimicrobials is a treatment strategy for severe Klebsiella infections.

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Section: Discussionmentioning

confidence: 99%

Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome

Damor

Kubavat

2019

Int J Basic Clin Pharmacol

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“…Collectively, these benefits may positively impact technologist safety, workflow, costs, and throughput compared to other FDA-cleared molecular platforms and direct detection blood culture assays. Most importantly, the use of direct detection molecular blood culture assays, such as the iC-GPC Assay, will significantly reduce morbidity and mortality rates, shorten hospital stays, decrease costs, and favorably impact hospital antibiotic stewardship programs ( 25 – 29 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of the iCubate iC-GPC Assay for Detection of Gram-Positive Bacteria and Resistance Markers from Positive Blood Cultures

et al. 2018

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The iC-GPC Assay (iCubate, Huntsville, AL) is a qualitative multiplex test for the detection of five of the most common Gram-positive bacteria (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis, and Enterococcus faecium) responsible for bacterial bloodstream infections, performed directly from positive blood cultures. The assay also detects the presence of the mecA, vanA, and vanB resistance determinants.

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“…Previous studies of RMPT for septicemia have also demonstrated both cost savings and survival benefits [31,32]. The test with the most extensive evidence of cost savings is PNA FISH (peptide nucleic acid fluorescent in situ hybridization), one of the earliest molecular methods used in rapid pathogen identification and one of the easiest to implement.…”

Section: Other Studiesmentioning

confidence: 99%

New Pathologist Roles In Value-Based Care: Rapid Molecular Pathogen Testing Reduces Hospital Septicemia Costs

Herriman¹

2014

J Health Med Inform

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By enabling earlier and more appropriate treatment, rapid molecular pathogen testing (RMPT) can greatly improve the management of acute infectious disorders, such as septicemia. Molecular testing for septicemia offers opportunities to generate substantial value but requires pathologists to expand and/or assume new roles, including:• Technological and administrative leadership of a complex, rapidly changing field • Physician education programs to translate science into clinical interventions • Integration of laboratory and clinical services • Value-based economic decision-making in a clinical environment.This paper explores the issues that call for new pathologist roles in molecular pathogen testing, reviews recent literature to assess the value of such testing in treating septicemia, and models potential cost savings for institutions of various sizes.Two recent U.S. studies of this testing included the impact on hospital costs. Both studies evaluated clinical participation and close collaboration by pharmacists and laboratory professionals in a coordinated septicemia management program. Comparison of patients evaluated with RMPT versus traditional culture-based testing found significant decreases in septicemia-related costs at two hospitals (30-43%, or approximately $20,000/patient in direct cost savings). Extrapolating this data to the typical 200-750-bed hospital indicates potential, annual net savings of $3-6 million per hospital.Clearly, institutions that implement RMPT for septicemia can generate substantial value, if pathologists expand and/ or assume new roles and responsibilities. Optimally mapping the analytic performance of complex molecular tests to clinical settings with variable types of resistant pathogens and disorders requires the expertise of physician pathologists.

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The Utility of Rapid Microbiological and Molecular Techniques in Optimizing Antimicrobial Therapy

Cited by 5 publications

References 18 publications

Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome

Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome

Clinical Evaluation of the iCubate iC-GPC Assay for Detection of Gram-Positive Bacteria and Resistance Markers from Positive Blood Cultures

New Pathologist Roles In Value-Based Care: Rapid Molecular Pathogen Testing Reduces Hospital Septicemia Costs

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