Clinical and Economic Impact of Rapid Blood Pathogen Identification Via Verigene.

INTRODUCTION

Bloodstream infections (BSIs) are associated with increased morbidity and mortality if not treated appropriately. Rapid identification of microorganisms will allow clinicians the opportunity to modify initial broad-spectrum antibiotic therapy and improve patient outcomes in bacteremia. We aim to evaluate the impact of the Verigene Gram-positive blood culture (BC-GP) technology on time to modification of antibiotic therapy by clinicians.

METHODS

This was a retrospective research study conducted at Corpus Christi Medical Center. Verigene BC-GP technology was employed to rapidly identify microorganisms in patients with suspected Gram-positive bacteremia. Empiric antibiotic therapy was modified via de-escalation or escalation when culture results became available. The primary outcome for this study was the mean time to modification of antibiotic therapy after Verigene BC-GP results became available. Data analysis was conducted from data collected between January 2015 and August 2017 to assess the clinical and pharmacoeconomic impact of BC-GP.

RESULTS

Data were collected on 159 patients, with 123 of 159 (77%) meeting the inclusion criteria. The mean age was 66 ± 14.9 years, with 53/123 (43%) females and 70/123 (57%) males. Positive cultures identified were as follows: Streptococcus species (34), Staphylococcus species (72), 31/72 (43%) were MRSA, and Enterococcus species (19), 4/19 (21%) were Vancomycin-resistant Enterococcus (VRE). Antibiotic therapies in 31 of 123 patients (25%) were escalated, and 29 of 123 (24%) were de-escalated. Therapy was determined to be appropriate based on culture results in 63 of 123 (51%) patients, and thus therapy was not modified in this group. The mean time to escalate therapy was 6.2 ± 6 h and 9.2 ± 12.1 h to de-escalate. The average time for modification of antibiotic therapy was 7.6 ± 9.5 h. The conventional approach would take approximately 24-72 h for pathogen identification. Data on cost savings per intervention is estimated to be approximately $4000 per intervention. Based on this model, we estimate approximately $240,000 in cost savings from the 60 cases where interventions occurred.

CONCLUSION

There is a significant time advantage to pathogen identification, therapy modification as well as a pharmacoeconomic benefit associated with the Verigene GC-GP system as compared to the conventional approach, which translates to positive patient outcomes.