224. Impact of a Novel Staphylococcal Bacteremia Rapid Diagnostic Test on Antimicrobial Therapy at an Academic Medical Center
Session: Poster Abstract Session: Diagnostic Microbiology
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDWeek 2013 Poster_KeyPath Study_Final.pdf (1.2 MB)
  • Background:

    Infections due to Staphylococcus aureus can be serious and often fatal, resulting in increased utilization of healthcare resources. The KeyPath MRSA/MSSA Blood Culture Test is a novel rapid diagnostic test that decreases time to identification and susceptibility of S. aureus by utilizing S. aureus-specific bacteriophage replication, revealing identification and susceptibility data within 6 hours of positive blood cultures potentially allowing for earlier initiation of targeted antimicrobial therapy. 

    Methods:

    The primary objective of this study was to determine if time to initiation of targeted antimicrobial therapy would decrease upon implementation of this rapid diagnostic test. Secondary objectives evaluated the potential impact on hospital length of stay and mortality. This IRB-approved, retrospective chart review evaluated data six months prior to and six months after test implementation. Patients with blood cultures positive for Gram-positive cocci in clusters were identified via microbiology records. The first positive blood cultures which grew Gram-positive cocci in clusters in adult patients were included and cultures positive for multiple organisms were excluded.

    Results:

    The pre-implemetation group evaluated 118 patients and 74 patients were evaluated in the post-implementation group. Pre-implementation cultures included coagulase-negative staphylococci (CoNS) (52.5%), methicillin-susceptible S. aureus (MSSA) (27.9%) and methicillin-resistant S. aureus (MRSA) (19.5%). Post-implementation cultures included CoNS (12.2%), MSSA (48.7%) and MRSA (39.2%). Time to initiation of targeted antimicrobial therapy after positive blood cultures was approximately 41 hours prior to technology implementation and approximately 14 hours after implementation. Pre- and post- implementation length of stay was 12 days and 14 days, respectively. Pre- and post-implementation mortality was 8.5% and 10.8%, respectively. Statistical analysis included Kaplan-Meier, Fisher’s exact and Wilcoxin rank sum tests.

    Conclusion:

    The initiation of this novel rapid diagnostic test resulted in earlier initiation of targeted antimicrobial therapy. This test did not shorten hospital length of stay or decrease mortality.

    Jazmine Okuboyejo, PharmD1, Amy N. Schilling, PharmD1, Eddie Lee, PharmD1, Michael Loeffelholz, PhD2 and Natalie Williams-Bouyer, PhD3, (1)UTMB Health, Galveston, TX, (2)Pathology, UTMB Health, Galveston, TX, (3)Department of Pathology, UTMB Health and Clinical Laboratory Services, Shriners Hospitals for Children, Galveston, TX

    Disclosures:

    J. Okuboyejo, None

    A. N. Schilling, None

    E. Lee, None

    M. Loeffelholz, None

    N. Williams-Bouyer, 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.