1859. Multiplex Respiratory Viral Panel Use In The Intensive Care Unit And Its Effect On Antibiotic Usage And Patient Outcomes.
Session: Poster Abstract Session: Antibiotic Stewardship: Diagnostics
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • IDSA POSTER RVP FINAL VERSION.pdf (269.6 kB)
  • Background:

    Pneumonia is the top cause of mortality of all age groups in the United States. Patients admitted to the intensive care unit (ICU) have a high use of empiric antibiotics for treatment. Some of these infections can be viral. Because antiviral therapies are limited to certain viruses, it is argued that identification of viruses for which there is no therapy does not alter patient management. Our study looks at the use of the multiplex respiratory viral panel (MRVP) test and its effect on antibiotic usage and outcomes in the ICU.

    Methods:

    Retrospective cohort. Single site, 1300 bed university hospital. All ICU patients with diagnosis of pneumonia who had an MRVP from November 2011 to June 2015 were included. Prisoners, patients less than 18 years old and patients with a bacterial pneumonia were excluded. Categorical variables assessed using the chi-square test. Continuous variables described using the Student’s t-test. All data analyzed using JMP statistical software.

    Results:

    11,991 patients had an MRVP performed between November 2011 and June 2015. After inclusion and exclusion criteria we had 2,068 patients; 535 patients with a positive and 1533 with a negative MRVP. 425 from each group were randomized for inclusion.

    Demographics

    MRVP NEGATIVE (n=425)

    MRVP POSITIVE

    (n=425)

    Gender

    Male

    46.2% (n=229)

    51.1% (n=217)

    Female

    53.8% (n=196)

    48.9% (n=208)

    Race

    White

    75.7% (n=322)

    75.7% (n=322)

    Black

    18.2% (n=77)

    18.8% (n=80)

    Mean age at visit (SD)

    57.6 (15.8)

    57.6 (16.2)

    Mean Body Mass Index (SD)

    30.4 (9.3)

    29.8 (9.9)

    Charlson Comorbidity Score (SD)

    5.84 (5.45)

    5.38 (4.81)

    Chronic Lung Disease (YES)

    47.7% (n=203)

    47.7% (n=203)

    Outcomes

    MRVP NEGATIVE (n=425)

    MRVP POSITIVE

    (n=425)

    p-value

    Mean duration of antibiotic use

    17.69 days

    14.47 days

    0.0003

    Mean length of ICU stay

    12.37 days

    10.44 days

    0.0376

    Mean length of hospital stay

    10.83 days

    9.44 days

    0.0213

    30 day attributable mortality

    28.5%

    18.12%

    0.0004

    Conclusion:

    Patients who had a positive MRVP had a shorter duration of aggregate antibiotic use, mean length of ICU and hospital stay and reduced 30-day attributable mortality. This study might indicate a utility of the MRVP for antimicrobial management in the ICU. Further studies are indicated
    .

    Cory Hussain, MBBS, The Ohio State University Wexner Medical Center, Columbus, OH, Joan-Miquel Balada-Llasat, Pharm D, PhD, Ohio State University Medical Center, Columbus, OH, Preeti Pancholi, PhD, Clinical Microbiology, The Ohio State Univ Med Ctr, Columbus, OH and Kurt Stevenson, MD, MPH, FSHEA, Department of Internal Medicine, Division of Infectious Diseases, The Ohio State University, Columbus, OH

    Disclosures:

    C. Hussain, None

    J. M. Balada-Llasat, None

    P. Pancholi, None

    K. Stevenson, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.