AcceleratephenoTM Potential Influence on Timeliness of Management Decisions for Patients with Positive Blood Cultures.
CCCF ePoster library. Grant J. Nov 8, 2018; 233325
Disclosure(s): The poster presented was supported by AcceratePheno including in-kind donation of materials and support for independent statistical analysis.
Jennifer Grant
Jennifer Grant
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Abstract
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Objective

There is a direct relationship between appropriate antibiotic administration and survival in patients with sepsis encouraging broad spectrum drugs, while use of narrower spectrum antibiotics reduces adverse events and development of resistance. Rapid diagnostic testing allows more timely and accurate antibiotic prescription, thus improving clinical outcomes in patients with positive blood-cultures. The AcceleratephenoTM system (AXDX) is a platform for rapid identification (ID – 90 minutes) and susceptibility testing (AST – <7 hours) from positive blood culture bottles. We assessed the potential of AXDX results to influence more timely antibiotic tailoring interventions on a convenience sample of 154 positive blood cultures from unique patients.

Materials and Methods

Blood cultures with a gram stain for a single organism likely to be on the AXDX panel were run in parallel with the standard of care (SOC) when a trained technologist and machine was available for loading. Using results from the Standard of care (SOC), Medical Microbiologists noted interventions made at the time of blood culture gram stain, organism identification and AST result availability.  The timing of MM intervention was noted and compared to fastest potential time in SOC and with AXDX timing.

Results

Of 154 cultures assessed by AXDX, 148 resulted in actions by either the microbiologist or medical team; 113 (76%) of which were attributable to data available from AXDX. The most common AXDX attributable intervention was narrowing of antibiotics in 76 (67%) cases, followed by escalation of therapy in 24 (21%) instances or recommending a specialist consult (5%). Compared to SOC, AXDX results were 15.8±12.6h faster to organism ID. Likewise for AST, time-saving was 28.3±11.6h. Given the time saving, it would be possible to save 34 days of broad spectrum therapy by using AXDX for more timely results. For those patients requiring broader therapy, time delay to correct therapy could be decreased by 18h on average.

Conclusions

There is significant potential for results from rapid diagnostic panels such as AXDX to support timely antimicrobial prescribing and other management decisions to benefit patients.  Next steps include identifying septic patients in the ICU who would benefit from timelier reporting of antimicrobial susceptibility.

 


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