Collaboration between an antimicrobial stewardship team and the microbiology laboratory can shorten time to directed antibiotic therapy for methicillin-susceptible staphylococcal bacteremia and to discontinuation of antibiotics for coagulase-negative staphylococcal contaminants

Tanaya Bhowmick, Thomas J. Kirn, Frances Hetherington, Shandurai Takavarasha, Sarbjit S. Sandhu, Shveta Gandhi, Navaneeth Narayanan, Melvin P. Weinstein

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: Rapid identification of Gram-positive cocci in clusters (GPCC) in positive blood cultures (pBC) may limit exposure to unnecessary or inappropriate antibiotics. Methods: Inpatients with pBC showing GPCC between October 2013 and December 2017 were included. In the baseline period (BL), final ID and susceptibility results were reported in the electronic medical record (EMR) within 48 h of telephoned Gram stain report. The laboratory introduced rapid phenotypic identification and direct susceptibility testing (INT1), later replaced by PCR (INT2). In the last Intervention (INT3), Antimicrobial Stewardship Response Team (ASRT) contacted providers with PCR results and recommendations. Results: Time to directed therapy (TDT) for MSSA and coagulase-negative Staphylococci (CoNS) decreased from BL to INT3 (48.5–17.9 h, 50.3–16.4 h, respectively). Time to ID from BL to INT3 for MSSA and CoNS also decreased (23.2–1.9 h, 44.7–2.8, respectively). Conclusions: TDT can be improved by modification of reporting methods with utilization of an ASRT.

Original languageEnglish (US)
Pages (from-to)214-219
Number of pages6
JournalDiagnostic Microbiology and Infectious Disease
Volume92
Issue number3
DOIs
StatePublished - Nov 2018

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Keywords

  • Antimicrobial stewardship
  • Coagulase-negative staphylococci
  • Methicillin sensitive Staphylococcus aureus
  • Rapid diagnostic tests
  • Staphylococcus aureus

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