Rapid Testing Using Verigene® BC-GN Microarray in Combination with Antimicrobial Stewardship Intervention in Gram-negative Bacteremia.
Antimicrob Agents Chemother. 2014 Dec 29;
Authors: Bork JT, Leekha S, Heil E, Zhao L, Badamas R, Johnson JK
Rapid identification of microorganism and antimicrobial resistance is paramount for targeted treatment in serious blood stream-infections (BSI). The Verigene® Gram-Negative Blood Culture Nucleic Acid Test (BC-GN) is a multiplex, automated molecular diagnostic test for identification of eight Gram-negative (GN) organisms and resistance markers from blood culture with a turnaround time of approximately 2 hours. Clinical isolates from adult patients at the University Maryland Medical Center with GN bacteremia from 1 January 2012 to 30 June 2012 were included in this study. Blood culture bottles were spiked with clinical isolates, allowed to incubate, and processed by BC-GN. A diagnostic evaluation was performed. In addition, a theoretical evaluation of time to effective and optimal antibiotic was performed, comparing actual antibiotic administration times from chart review ("control") to theoretical administration times based on BC-GN reporting and antimicrobial stewardship team (AST) review ("intervention"). For organisms detected by the assay, BC-GN correctly identified 95.6 % (131/137) with a sensitivity of 97.1% (95% CI 90.7 - 98.4%) and specificity of 99.5% (95% CI 98.8 - 99.8%). CTX-M and OXA resistance determinants were both detected. Allowing 12 h from Gram stain for antibiotic implementation, the intervention group had a significantly shorter duration to both effective (3.3 vs. 7.0 h, p < 0.01) and optimal (23.5 vs. 41.8 h, p < 0.01) antibiotic therapy. BC-GN with AST intervention can potentially decrease time to both effective and optimal antibiotic therapy in GN BSI.
PMID: 25547353 [PubMed - as supplied by publisher]