Benefits of adding a rapid pcr-based blood culture identification panel to an established antimicrobial stewardship program
Open accessAbstract
Studies have demonstrated that the combination of antimicrobial stewardship programs (ASP) and rapid organism identification improves outcomes in bloodstream infections (BSI) but have not controlled for the incremental contribution of the individual components. Hospitalized adult patients with blood culture pathogens on a rapid, multiplex PCR-based blood culture identification panel (BCID) that included 19 bacterial species, 5 Candida spp., and 4 antimicrobial resistance genes were studied over sequential time periods in a pre-post quasiexperimental study in 3 groups in the following categories: conventional organism identification (controls), conventional organism identification with ASP (AS), and BCID with ASP (BCID). Clinical and economic outcomes were compared between groups. There were 783 patients with positive blood cultures; of those patients, 364 (115 control, 104 AS, and 145 BCID) met inclusion criteria. The time from blood culture collection to organism identification was shorter in the BCID group (17 h; P < 0.001) than in the control group (57 h) or the AS group (54 h). The BCID group had a shorter time to effective therapy (5 h; P < 0.001) than the control group (15 h) or AS group (13 h). The AS (57%) and BCID (52%) groups had higher rates of antimicrobial de-escalation than the control group (34%), with de-escalation occurring sooner in the BCID group (48 h; P = 0.034) than in the AS group (61 h) or the control group (63 h). No difference between the control group, AS group, and BCID group was seen with respect to mortality, 30-day readmission, intensive care unit length of stay (LOS), postculture LOS, or costs. In patients with BSI, ASP alone improved antimicrobial utilization. Addition of BCID to an established ASP shortened the time to effective therapy and further improved antimicrobial use compared to ASP alone, even in a setting of low antimicrobial resistance rates.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Antimicrobial stewardship programs are optimally positioned to improve response and outcomes associated with RDTs.
“Antimicrobial stewardship programs (ASP) are optimally positioned to improve response and outcomes associated with RDTs.”
Macvane and colleagues showed that compared with no intervention and ASP alone, ASP plus BCID decreased time to effective therapy and produced more rapid de-escalation in patients with positive blood cultures.
“Macvane and colleagues showed that compared with no intervention and ASP alone, ASP plus BCID decreased time to effective therapy in patients and more rapid de-escalation in patients with positive blood cultures [20].”
The best evidence for impact of ASP with RDTs is with multiplex PCR-based blood culture identification (BCID) panels.
“The best evidence for impact of ASP with RDTs is with multiplex PCR-based blood culture identification (BCID) panels [20,21].”
Cites
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2008.08.010 · Cited by 51,384 · see citing works
Dellit, T. H., Owens, R. C., McGowan, J. E., Gerding, D. N., Weinstein, R. A., Burke, J. P., Huskins, W. C., Paterson, D. L., Fishman, N. O., Carpenter, C. F., et al. (2006) · Clinical Infectious Diseases · doi:10.1086/510393 · Cited by 3,366 · see citing works
Cosgrove, S. E. (2006) · Clinical Infectious Diseases · doi:10.1086/499406 · Cited by 1,271 · see citing works
Banerjee, R., Teng, C. B., Cunningham, S. A., Ihde, S. M., Steckelberg, J. M., Moriarty, J. P., Shah, N. D., Mandrekar, J. N., & Patel, R. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ447 · Cited by 570 · see citing works
Tumbarello, M., Sanguinetti, M., Montuori, E. A., Trecarichi, E. M., Posteraro, B., Fiori, B., Citton, R., D’Inzeo, T., Fadda, G., Cauda, R., et al. (2007) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01509-06 · Cited by 459 · see citing works
Buehler, S., Madison, B. M., Snyder, S. R., Derzon, J. H., Cornish, N. E., Saubolle, M. A., Weissfeld, A. S., Weinstein, M. P., Liebow, E., & Wolk, D. M. (2015) · Clinical Microbiology Reviews · doi:10.1128/cmr.00053-14 · Cited by 297 · see citing works
Altun, O., Almuhayawi, M. S., Ullberg, M., & Özenci, V. (2013) · Journal of Clinical Microbiology · doi:10.1128/jcm.01835-13 · Cited by 285 · see citing works
Review of Rapid Diagnostic Tests Used by Antimicrobial Stewardship Programs
Bauer, K. A. A., Perez, K. K., Forrest, G. N., & Goff, D. A. (2014) · Clinical Infectious Diseases · doi:10.1093/cid/ciu547 · Cited by 255 · see citing works
Salimnia, H., Fairfax, M. R., Lephart, P., Schreckenberger, P. C., DesJarlais, S., Johnson, J. K., Robinson, G. L., Carroll, K. C., Greer, A. E., Morgan, M. A., et al. (2016) · Journal of Clinical Microbiology · doi:10.1128/jcm.01679-15 · Cited by 246 · see citing works
Bacteremias: A Leading Cause of Death
Bearman, G. M., & Wenzel, R. P. (2005) · Archives of Medical Research · doi:10.1016/j.arcmed.2005.02.005 · Cited by 215 · see citing works
Blaschke, A. J., Heyrend, C., Byington, C. L., Fisher, M. A., Barker, E. P., Garrone, N. F., Thatcher, S. A., Pavia, A. T., Barney, T., Alger, G., et al. (2012) · Diagnostic Microbiology and Infectious Disease · doi:10.1016/j.diagmicrobio.2012.08.013 · Cited by 208 · see citing works
Fredricks, D. N., & Relman, D. A. (1998) · Journal of Clinical Microbiology · doi:10.1128/jcm.36.10.2810-2816.1998 · Cited by 203 · see citing works
Ledeboer, N. A., Lopansri, B. K., Dhiman, N., Cavagnolo, R. Z., Carroll, K. C., Granato, P. A., Thomson, R., Butler‐Wu, S. M., Berger, H., Samuel, L. P., et al. (2015) · Journal of Clinical Microbiology · doi:10.1128/jcm.00581-15 · Cited by 163 · see citing works
Klevens, R. M., Edwards, J. R., Gaynes, R. P., & System, N. N. I. S. (2008) · Clinical Infectious Diseases · doi:10.1086/591698 · Cited by 133 · see citing works
Buchan, B. W., Ginocchio, C. C., Manii, R., Cavagnolo, R. Z., Pancholi, P., Swyers, L., Thomson, R. B., Anderson, C. J., Kaul, K. L., & Ledeboer, N. A. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001478 · Cited by 131 · see citing works
Temporal effects of antibiotic use and Clostridium difficile infections
Vernaz, N., Hill, K., Leggeat, S., Nathwani, D., Philips, G., Bonnabry, P., & Davey, P. G. (2009) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkp128 · Cited by 45 · see citing works
Pence, M. A., McElvania, E., & Burnham, C. D. (2013) · Clinics in Laboratory Medicine · doi:10.1016/j.cll.2013.03.010 · Cited by 36 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Syndromic Panel-Based Testing in Clinical Microbiology
Ramanan, P., Bryson, A. L., Binnicker, M. J., Pritt, B. S., & Patel, R. (2018) · Clinical Microbiology Reviews · doi:10.1128/cmr.00024-17 · Cited by 308 · see citing works
Panels and syndromic testing in clinical microbiology
Dien Bard, J., & McElvania, E. (2020) · Clinics in Laboratory Medicine · doi:10.1016/j.cll.2020.08.001 · Cited by 92 · see citing works
Dumkow, L. E., Worden, L. J., & Rao, S. N. (2021) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkab245 · Cited by 57 · see citing works
Chang, D., Okulicz, J. F., Nielsen, L. E., & White, B. K. (2018) · Military Medicine · doi:10.1093/milmed/usx025 · Cited by 30 · see citing works
Markovich, K., Wingler, M. J. B., Stover, K. R., Barber, K. E., Wagner, J. L., & Cretella, D. A. (2022) · Diseases · doi:10.3390/diseases10040110 · Cited by 22 · see citing works
- Authors
- MacVane, S. H., & Nolte, F. S.
- Affiliations
- Medical University of South Carolina (US)
- Venue
- Journal of Clinical Microbiology
- Publisher
- American Society for Microbiology
- Published
- 2016-10
- Volume
- 54
- Issue
- 10
- Pages
- 2455-2463
- ISSN
- 0095-1137 (ISSN-L)
- 1098-660X
- PMC
- PMC5035429
- OpenAlex
- W2496527871
- Cited by
- 167
- References
- 17
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 26 · 2023: 20 · 2022: 15 · 2021: 18 · 2020: 16 · 2019: 17 · 2018: 16 · 2017: 15 · 2016: 2
- FWCI
- 16.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Microbiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- BioFire Diagnostics
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Keywords
- antimicrobial stewardship, blood culture identification, multiplex PCR, bloodstream infection, antibiotic de-escalation, antimicrobial use, Candida, antimicrobial resistance genes, hospital costs
- MeSH terms
- Blood Culture, Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Drug Utilization, Female, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Time Factors, Polymerase Chain Reaction, Bacteremia, Treatment Outcome, Young Adult, Candidemia, Non-Randomized Controlled Trials as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
