The impact of blood culture identification by MALDI-TOF MS on the antimicrobial management of pediatric patients

被引:14
作者
Bhavsar, Sejal Makvana [1 ]
Dingle, Tanis C. [2 ]
Hamula, Camille L. [2 ]
机构
[1] Icahn Sch Med Mt Sinai, Div Pediat Infect Dis, Dept Pediat, New York, NY 10029 USA
[2] Icahn Sch Med Mt Sinai, Div Clin Microbiol, Dept Pathol, New York, NY 10029 USA
关键词
Antimicrobial stewardship; Pediatrics; MALDI-TOF; INTEGRATING RAPID DIAGNOSTICS; PATHOGEN IDENTIFICATION; STEWARDSHIP; THERAPY; TIME;
D O I
10.1016/j.diagmicrobio.2018.05.021
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objective: To assess the impact of MALDI-TOF MS coupled with antimicrobial stewardship on clinical outcomes for pediatric inpatients with bloodstream infections. Methods: Outcomes of pediatric inpatients were compared before and after MALDI-TOF MS implementation. Outcomes measured included time until organism identification and susceptibility, duration of antibiotics, patient length of stay (LOS), mortality and hospital costs. Results: 210 and 135 patient events were compared pre- and post-intervention. Average time to organism identification decreased from 41 to 11 hours (P = <0.0001). Time to i) susceptibilities decreased from 50.8 to 37.7 hours (P = <0.0001), ii) de-escalation of antibiotics decreased from 58 to 23 hours (P = <0.0001), iii) discontinuation of unnecessary antibiotics decreased from 49 to 20 hours (P = <0.0001). Infection-related LOS decreased from 10.5 to 8.37 days (P = 0.006). No significant differences were seen for other outcomes. Conclusions: MALDI-TOF MS identification of bacteria from blood culture broth improves time to appropriate antibiotic treatment for pediatric inpatients. (C) 2018 Elsevier Inc. All rights reserved.
引用
收藏
页码:220 / 225
页数:6
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