학술논문
Randomized Trial Evaluating Clinical Impact of RAPid IDentification and Susceptibility Testing for Gram-negative Bacteremia: RAPIDS-GN.
Document Type
article
Author
Banerjee, Ritu; Komarow, Lauren; Virk, Abinash; Rajapakse, Nipunie; Schuetz, Audrey N; Dylla, Brenda; Earley, Michelle; Lok, Judith; Kohner, Peggy; Ihde, Sherry; Cole, Nicolynn; Hines, Lisa; Reed, Katelyn; Garner, Omai B; Chandrasekaran, Sukantha; de St Maurice, Annabelle; Kanatani, Meganne; Curello, Jennifer; Arias, Rubi; Swearingen, William; Doernberg, Sarah B; Patel, Robin
Source
Clinical Infectious Diseases. 73(1)
Subject
Language
Abstract
BackgroundRapid blood culture diagnostics are of unclear benefit for patients with gram-negative bacilli (GNB) bloodstream infections (BSIs). We conducted a multicenter, randomized, controlled trial comparing outcomes of patients with GNB BSIs who had blood culture testing with standard-of-care (SOC) culture and antimicrobial susceptibility testing (AST) vs rapid organism identification (ID) and phenotypic AST using the Accelerate Pheno System (RAPID).MethodsPatients with positive blood cultures with Gram stains showing GNB were randomized to SOC testing with antimicrobial stewardship (AS) review or RAPID with AS. The primary outcome was time to first antibiotic modification within 72 hours of randomization.ResultsOf 500 randomized patients, 448 were included (226 SOC, 222 RAPID). Mean (standard deviation) time to results was faster for RAPID than SOC for organism ID (2.7 [1.2] vs 11.7 [10.5] hours; P