232. Unmet Diagnostic Needs in Infectious Disease
Session: Poster Abstract Session: Diagnostic Microbiology
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Blaschke_40150_Unmet Diagnostic Needs_Poster_IDSA 2013_2.pdf (1.9 MB)
  • Background: Accurate and timely diagnostics can improve patient care and antibiotic stewardship. New technologies for infectious disease (ID) are emerging but gaps remain in test development and availability. The Emerging Infections Network (EIN) and members of the IDSA Diagnostics Task Force surveyed clinical ID physicians to assess their unmet diagnostic needs.

    Methods: 1572 EIN members were surveyed in March 2013. Respondents ranked or scored [(1) least important to (5) greatest need] unmet diagnostic needs for infectious syndromes, pathogens and antibiotic resistance. Additional free text answers were encouraged.  

    Results: 700 members (44.5%) completed the survey. Results are shown in the table. Identification of resistant Gram-negative bacilli and rapid ESBL testing ranked 1st in the pathogen and resistance categories. Culture-negative endocarditis was the syndrome with greatest unmet need followed by infectious diarrhea. Pathogen-based testing for respiratory infection (18% of write-ins), followed by tests to distinguish viral vs. bacterial infection (16%) were named most frequently as potentially useful tests not invented or not available in respondents’ current practice. Accuracy and turn around time were the most important test characteristics (mean scores 4.72 and 4.61), outranking cost (4.07). A majority (67%) of respondents felt that some testing is too complex for non-ID physicians; 79% thought there should be stewardship for complex or expensive tests (e.g., multiplex testing for respiratory viruses [13% of write-ins] and broad range PCR [9%]).

    Conclusion: The call for tests to identify resistant Gram-negative bacteria reflects increasing drug-resistant infections and limited drug development. Recognition of the importance of judicious testing through stewardship parallels increased awareness of rising healthcare costs. Information gained from this survey can help inform recommendations for new diagnostic test development in the future. 

    Rank

    Syndrome

    Rank

    Pathogen

    Rank

    Resistance

    1

    Culture-negative endocarditis

    1

    Resistant Gram-negatives

    1

    ESBL

    2

    Infectious diarrhea

    2

    Resistant M. tuberculosis

    2

    KPC

    3

    Febrile neutropenia

    3

    Influenza

    3

    mecA

    4

    CAP

    4

    MRSA

    4

    Fluconazole

    5

    CNS infection

    5

    HIV resistance

    5

    vanA/B

    6

    Sepsis

    6

    Mold (species ID)

    6

    INH

    Anne J. Blaschke, MD, PhD1, Adam L. Hersh, MD, PhD1, Susan E. Beekmann, RN, MPH2,3, Dilek Ince, MD2, Philip M. Polgreen, MD2,3 and Kimberly E. Hanson, MD, MHS4, (1)Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, (2)Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, (3)Emerging Infections Network, Iowa City, IA, (4)University of Utah School of Medicine, Salt Lake City, UT

    Disclosures:

    A. J. Blaschke, BioFire Diagnostics, Inc.: Collaborator, Licensing agreement or royalty

    A. L. Hersh, None

    S. E. Beekmann, None

    D. Ince, None

    P. M. Polgreen, None

    K. E. Hanson, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.