Rapid Reporting of Bacterial Identification Impacts Clinical Outcome

The clinical and economic impact of rapid microbiological reporting on the specimens most frequently processed by the Microbiology Laboratory has been assessed.

Inappropriate antibiotic prescriptions are associated with an increase in healthcare costs and a decrease in the quality of care and therefore the quicker the laboratory can identify the causative organism and antibiotic sensitivity, both parameters can be improved.

At the Clínica Universidad de Navarra (Pamplona, Spain) investigators collected data over a period of four consecutive years, from December 2003 until December 2007. A historical control group from December 2003 until December 2005 was studied retrospectively, and an intervention group from December 2005 until December 2007 was studied prospectively. Only hospitalized patients with bacterial infections were included. The Vitek2 system was used for identification and susceptibility testing. For the economic study, direct fixed costs, direct variable costs, and indirect costs during hospitalization were considered.

The median length of time from the introduction of the microorganism in the Vitek 2 system until microbiological report were significantly different as follows: wound and abscess samples, control group 23.5 hours, intervention group 9.5 hours; blood samples, control group 23.5 hours, intervention group 9.2 hours, and urine samples control group 23.4 hours , intervention group 9.3 hours. The median time that elapsed between entering of the bacterial isolate into the Vitek2 system (bioMérieux, Marcy-l'Étoile, France) and the reporting of the results to the physician by the Laboratory Information System and/or by telephone was significantly less in the intervention group than in the control group.

The results of the study suggested that shortening the turnaround time of microbiological procedures and notification makes early initiation and/or optimization of antimicrobial therapy possible. This resulted in a reduction in the number of hospital days, a decrease in antibiotic use, and, as a consequence, a significant reduction in the total costs. The results could also apply to other early information methods, such as real-time polymerase chain reaction (rt-PCR) methods or matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. The study was published on March 8, 2012, in the European Journal of Clinical Microbiology & Infectious Diseases.

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Clínica Universidad de Navarra
BioMérieux