Impact of FilmArray Technology for Rapid Identification of Bacteremias in a Community Teaching Hospital

Background: Summa Akron City Hospital (SACH) recently acquired rapid diagnostic technology known as FilmArray Multiplex Polymerase Chain Reaction (PCR). This technology is FDA approved, and is expected to result in the rapid identification of microorganisms within the bloodstream. The purpose of this quality improvement project was to determine the impact of the introduction of this technology on surrogate and clinical outcomes in bacteremic patients at SACH.

Methods: A retrospective chart review was performed for all patients who presented to SACH with confirmed bacteremias with one or more pathogens identified. Data was collected for identified subjects from the months of June 2015 (pre-implementation of FilmArray PCR technology) and November 2015 (post-implementation of the technology). The primary objectives included time to effective and optimal antimicrobial therapy. Secondary outcomes included 30-day and all cause mortality, length of stay in the intensive care unit (ICU), length of hospital stay, time to identification of primary pathogen(s), and overall cost of antimicrobial therapy. Bacteremias identified included all Gram-positive, Gram-negative, and anaerobic pathogens.

Results: Of 200 patients evaluated for possible inclusion, 181 meeting the pre-determined requirements were included in the study (pre-intervention group n=87; post-intervention group n=93). Post PCR implementation, the mean time to optimal therapy was reduced from 30.6 hours (±34.35 hours) to 1.7 hours (±2.25 hours) (P<0.001); the 30 day readmission rate was reduced from 29.3% to 4.3% (P<0.001); inpatient mortality rate was reduced from 18.8% to 8.6% (P=0.046). Cost per day of antimicrobial therapy per patient was on average $79.50 less in the intervention group compared with the pre-intervention group ($121.10 vs. $41.60; P=0.012).

Conclusion: The implementation of the FilmArray Multiplex PCR technology significantly decreased time to optimal antimicrobial therapy in patients that presented with bacteremias at SACH. Additional observed benefits include reductions in readmissions, inpatient mortality, time to bacterial identification, and costs.