Gram-Positive Organisms in Blood Cultures

Bloodstream infections (BSI) constitute a growing public health concern in the industrialized world. With an associated death toll of approximately 36,000 individuals per year, BSIs ranked as the 11th leading cause of death in the US. In addition to being an important cause of morbidity and mortality, BSIs are an economic burden for healthcare institutions and patients.

Gram-Positive Organisms
By identifying the causative organism and performing antibiotic susceptibilities testing (AST), the laboratory provides crucial information to guide the correct treatment for patients with BSIs. In spite of being the gold standard, culture-based methods for identification and antibiotic susceptibilities are time consuming, which leads to patients not receiving specific antibiotic therapy promptly, increasing patient and hospitals’ costs by means of inappropriate therapy and longer stay. In this era of drug resistant pathogens, practitioners are often obligated to prescribe broad spectrum antibiotics, which are often more expensive, may be associated with drug toxicities necessitating monitoring, and in worst case scenarios lead to additional antimicrobial resistance. Furthermore, incorrect antibiotic therapy administration has been shown to be associated with increased risk of mortality, particularly during the first 24 hours of infection. With the advent of molecular techniques developed to detect bacterial genetic information, the turnaround time of pathogen identification and markers of resistance has been greatly reduced. Nevertheless, many of these molecular techniques require a certain level of expertise to be executed in the routine microbiology laboratory. In recent years, microarray-based tests have emerged as a strong and reliable alternative to PCR-based methods. In our study we focused on implementing a user-friendly microarray-based platform. Previous studies have evaluated the performance of such platform , but only one paper to date has focused on the economic impact of Enterococci detection. In addition, studies focused on the economic value of detection of multiple gram-positive organisms using this microarray technology are lacking. We sought to assess the impact of using the Verigene BC-GP test results on the following parameters: antibiotic therapy intervention, drug monitoring decisionmaking, decision to admit or discharged based on pathogenicity or the organism.

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