Clinical Impact of the Verigene® Blood Culture System on Rapid Diagnosis and Antibiotic Optimization in Bacteremic Solid Organ Transplant (SOT) Recipients.
1Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA
2Division of Nephrology, Drexel University College of Medicine, Philadelphia, PA
3Department of Surgery, Drexel University College of Medicine, Philadelphia, PA
4Pharmacy, Hahnemann University Hospital, Philadelphia, PA
5Microbiology, Hahnemann University Hospital, Philadelphia, PA.
Meeting: 2016 American Transplant Congress
Abstract number: 165
Keywords: Bacterial infection, Infection
Session Information
Date: Sunday, June 12, 2016
Session Name: Concurrent Session: Organ Transplantation in the Era of Highly Resistant Pathogens
Session Time: 4:30pm-6:00pm
Presentation Time: 5:30pm-5:42pm
Location: Room 311
Background:
Bloodstream infections are a major concern in SOT recipients and ineffective antibiotic therapy is strongly associated with poor outcomes. Rapid diagnostic tests (RDT) provide prompt identification of microorganisms and resistance markers, offering a unique collaborative opportunity for antimicrobial stewardship programs (ASP). We evaluated the effect of RDT coupled with an ASP communication on clinical outcomes and antibiotic optimization in bacteremic SOT recipients.
Methods:
RDT was performed using Verigene® Blood Culture System (Northbrook, IL) for gram positive and gram negative bacterial pathogens. Results were reported to the Infectious Diseases pharmacist who notified the practitioner and selected an appropriate treatment regimen per protocol. A retrospective chart review was performed to compare management of bacteremic patients pre and post implementation of the Verigene® System. The primary endpoints were time to bacterial identification and antibiotic switch.
Results:
Sixty-eight SOT recipients with bacteremia were included in our analysis; 39 in the pre-RDT group and 29 in the post-RDT group. After initiation of RDT, there was a decrease in time to bacterial identification (3:40 h:min [IQR, 2:39-6:05] vs. 48:39 h:min [IQR, 42:34-67:47] p <0.001 ) and time to antibiotic switch (11:44 h:min [IQR, 6:19-16:28] vs. 61:00 h:min [IQR, 54:49-109:42], p <0.001 ) in the post-RDT and pre-RDT groups respectively. Patients in the post-RDT group had a reduction in ICU length of stay (3 days [IQR 1-9] vs. 10 days [IQR, 8-17], p= 0.02), although no difference was observed in mortality endpoints.
Conclusion:
RDT coupled with an ASP communication resulted in faster identification of microorganisms, prompt deescalation or escalation of antibiotics, and reduced ICU length of stay with potential implications for improved clinical outcomes in SOT recipients with bacteremia.
CITATION INFORMATION: Law N, Malat G, Lee D, Doyle A, Emery C, Kyle K, Ranganna K, Harhay M, Bias T. Clinical Impact of the Verigene® Blood Culture System on Rapid Diagnosis and Antibiotic Optimization in Bacteremic Solid Organ Transplant (SOT) Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Law N, Malat G, Lee D, Doyle A, Emery C, Kyle K, Ranganna K, Harhay M, Bias T. Clinical Impact of the Verigene® Blood Culture System on Rapid Diagnosis and Antibiotic Optimization in Bacteremic Solid Organ Transplant (SOT) Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/clinical-impact-of-the-verigene-blood-culture-system-on-rapid-diagnosis-and-antibiotic-optimization-in-bacteremic-solid-organ-transplant-sot-recipients/. Accessed April 16, 2021.« Back to 2016 American Transplant Congress