Clinical impact of the accelerate PhenoTest® BC system on patients with gram-negative bacteremia and high risk of antimicrobial resistance: a prospective before-after implementation study

The Accelerate PhenoTest® BC system (AXDX) is a novel assay for rapid bacterial identification and antimicrobial susceptibility (AST). We report an evaluation of its impact on treatment of patients with Gram-negative bacteremia (GNB) with a high risk of antimicrobial resistance (AMR). A prospective...

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Published in:Annals of clinical microbiology and antimicrobials 2023-07, Vol.22 (1), p.62-62, Article 62
Main Authors: Brosh-Nissimov, Tal, Tzur, Anka, Grupel, Daniel, Cahan, Amos, Ma'aravi, Nir, Heled-Akiva, Maya, Jawamis, Hasan, Leskes, Hanna, Barenboim, Erez, Sorek, Nadav
Format: Article
Language:English
Subjects:
Antibiotic stewardship
Antibiotics
Antimicrobial agents
Antimicrobial resistance
Antimicrobial susceptibility testing
Antimicrobial treatment
Automation
Bacteremia
Bacteria
Care and treatment
Diagnosis
Disease susceptibility
Dosage and administration
Drug resistance
Drug resistance in microorganisms
Gram negative bacteremia
Identification
Infections
Infectious diseases
Intervention
Laboratories
Microbiology
Mortality
Patients
Polymicrobial bacteremia
Prevention
Rapid AST
Rapid identification
Risk factors
Stains & staining
Testing
Working hours
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Summary:The Accelerate PhenoTest® BC system (AXDX) is a novel assay for rapid bacterial identification and antimicrobial susceptibility (AST). We report an evaluation of its impact on treatment of patients with Gram-negative bacteremia (GNB) with a high risk of antimicrobial resistance (AMR). A prospective single-center evaluation before and after implementation of AXDX in addition to standard-of-care (SOC) microbiology and antimicrobial stewardship program (ASP). Patients with GNB reported during laboratory working hours and prespecified risk factors for AMR were included. The primary outcome was an ASP-oriented beneficial antimicrobial change, defined as either an escalation of an inappropriate empiric treatment or de-escalation of a broad-spectrum treatment of a susceptible organism. Main secondary outcomes were time to an appropriate treatment, antimicrobial treatment duration, length of stay (LOS) and mortality. Included were 46 and 57 patients in the pre- and post-intervention periods, respectively. The median time to an AST-oriented beneficial change was 29.2 h vs. 49.6 h, respectively (p 
ISSN:1476-0711
1476-0711
DOI:10.1186/s12941-023-00619-6