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[Rapid microbiological diagnosis of bacteremia in pediatrics: a quasi-experimental study].
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Pérez Guadalupe, Reijtman Vanesa, Taicz Moira, García M Eva, Padilla María Emilia, Mastroianni Alejandra, Arias Ana, Ferraro Daiana, Ferreres Lourdes, Picollo Micaela, Sarkis Claudia, Bologna Rosa
Аннотация
INTRODUCTION: Timely treatment of bacteremia is essential to reduce morbidity and mortality. Multidisciplinary collaboration and the use of rapid microbiological diagnostic methods are key to optimizing antibiotic (ATB) use.
AIMS: To compare reporting time, clinical outcomes, and antibiotic use in children with bacteremia before and after the integration of FilmArray® (FA) into an antibiotic stewardship program. Materials y methods: A quasi-experimental beforeand- after study was conducted to evaluate the integration of FA into an antibiotic stewardship program. Patients younger than 18 years with bacteremia hospitalized at a pediatric hospital were randomly included. Clinical, microbiological, and antibiotic-related variables were analyzed. Statistical analysis was performed using STATA 16.
RESULTS: A total of 173 patients were included: 88 in the pre-intervention period and 85 in the post-intervention period; 58 (57%) were male. The median age was 57 months (IQR: 16-112), and 142 patients (83%) had comorbidities. The groups were comparable. In the post-intervention period, there was a significant increase in the proportion of patients who underwent antibiotic adjustment (41% vs. 55%; p=0.01) and in adjustments made within the first 48 hours after blood culture collection (31% vs. 47%; p=0.02). A reduction in the number of days of empirical meropenem and vancomycin use was observed. Time to microbiological reporting decreased from 26 hours (IQR: 20-32) to 6 hours (IQR: 2-6) with FA (p=0.001).
CONCLUSION: The integration of FA within a multidisciplinary approach was associated with a reduction in time to microbiological reporting and optimization of antibiotic use.
AIMS: To compare reporting time, clinical outcomes, and antibiotic use in children with bacteremia before and after the integration of FilmArray® (FA) into an antibiotic stewardship program. Materials y methods: A quasi-experimental beforeand- after study was conducted to evaluate the integration of FA into an antibiotic stewardship program. Patients younger than 18 years with bacteremia hospitalized at a pediatric hospital were randomly included. Clinical, microbiological, and antibiotic-related variables were analyzed. Statistical analysis was performed using STATA 16.
RESULTS: A total of 173 patients were included: 88 in the pre-intervention period and 85 in the post-intervention period; 58 (57%) were male. The median age was 57 months (IQR: 16-112), and 142 patients (83%) had comorbidities. The groups were comparable. In the post-intervention period, there was a significant increase in the proportion of patients who underwent antibiotic adjustment (41% vs. 55%; p=0.01) and in adjustments made within the first 48 hours after blood culture collection (31% vs. 47%; p=0.02). A reduction in the number of days of empirical meropenem and vancomycin use was observed. Time to microbiological reporting decreased from 26 hours (IQR: 20-32) to 6 hours (IQR: 2-6) with FA (p=0.001).
CONCLUSION: The integration of FA within a multidisciplinary approach was associated with a reduction in time to microbiological reporting and optimization of antibiotic use.