Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025
Microbiology Laboratory Testing Practices of Gram-Negative Bloodstream Infections With Difficult-to-Treat Resistant Phenotypes in US Hospitals.
СтатьяНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
MacVane Shawn H, Moon Rena, David Joy, Rosenthal Ning, Humphries Romney M
Аннотация
BACKGROUND: Rapid administration of effective antimicrobial therapy is crucial for managing bloodstream infections (BSIs), especially those caused by pathogens with difficult-to-treat resistance (DTR; ie, resistance to all first-line antimicrobials). The purpose of this study is to describe the epidemiology and time course of microbiological testing in US laboratories for gram-negative BSIs (GN-BSIs).
METHODS: A retrospective observational cohort study of adults with GN-BSI between 1 January 2017 and 30 June 2023 was conducted using a large, geographically diverse, hospital-based administrative US database. Antimicrobial susceptibility testing (AST) reporting and time to results of traditional and next-generation antimicrobials (ceftazidime-avibactam, ceftolozane-tazobactam, cefiderocol, meropenem-vaborbactam, imipenem-relebactam) were evaluated according to the isolates' resistance phenotype.
RESULTS: A total of 110 322 GN-BSI episodes were included, of which 0.6% exhibited a DTR phenotype. Among all episodes, the average time to results for AST was 73.5 ± 26.7 hours from blood culture collection. The average time to AST results was longer for DTR (92.2 ± 27.8 hours) and carbapenem not-susceptible phenotypes (90.1 ± 28.0 hours) than for nonresistant phenotypes (72.9 ± 26.7 hours). Overall, 2.5% of GN-BSI episodes had AST reported for at least 1 next-generation antimicrobial, increasing from 0.2% in 2017 to 7.7% in 2023. Among patients with isolates showing DTR phenotypes, 30.5% had AST reported for at least 1 next-generation antimicrobial.
CONCLUSIONS: Time to AST results for next-generation antimicrobials and antibiotic-resistant organisms is prolonged in US laboratories for blood cultures with gram-negative organisms. Testing frequency and timing of AST reporting for next-generation antimicrobials likely contribute to their clinical utilization.
METHODS: A retrospective observational cohort study of adults with GN-BSI between 1 January 2017 and 30 June 2023 was conducted using a large, geographically diverse, hospital-based administrative US database. Antimicrobial susceptibility testing (AST) reporting and time to results of traditional and next-generation antimicrobials (ceftazidime-avibactam, ceftolozane-tazobactam, cefiderocol, meropenem-vaborbactam, imipenem-relebactam) were evaluated according to the isolates' resistance phenotype.
RESULTS: A total of 110 322 GN-BSI episodes were included, of which 0.6% exhibited a DTR phenotype. Among all episodes, the average time to results for AST was 73.5 ± 26.7 hours from blood culture collection. The average time to AST results was longer for DTR (92.2 ± 27.8 hours) and carbapenem not-susceptible phenotypes (90.1 ± 28.0 hours) than for nonresistant phenotypes (72.9 ± 26.7 hours). Overall, 2.5% of GN-BSI episodes had AST reported for at least 1 next-generation antimicrobial, increasing from 0.2% in 2017 to 7.7% in 2023. Among patients with isolates showing DTR phenotypes, 30.5% had AST reported for at least 1 next-generation antimicrobial.
CONCLUSIONS: Time to AST results for next-generation antimicrobials and antibiotic-resistant organisms is prolonged in US laboratories for blood cultures with gram-negative organisms. Testing frequency and timing of AST reporting for next-generation antimicrobials likely contribute to their clinical utilization.