661 - Cedars-Sinai, Iowa Hospitals & Clinics, Allegheny Health, UAMS
Antimicrobial use in patients with bloodstream infections from 4 hospitals in the Improving Outcomes and Antibiotic Stewardship (IOAS) study: a quasi-experimental multi-centre study of the Accelerate PhenoTest® BC Kit
S. Macvane, A. Bhalodi, R. Humphries, R. Dare, et al.
From the data
⁃ 760 patients of similar demographics, comorbidities, and severity of illness across multiple medical centers
⁃ Most prevalent organisms: E. coli (28), Klebsiella spp. (11%), and S. aureus (9%)
⁃ Median time to optimal therapy (TTOT) was 17.7 hours faster in the AXDX group [(40.9 (IQR, 21.1-58.4) SOC vs 23.2 (IQH, 10.2-36.6) AXDX]
⁃ Median time to first antibiotic intervention occurred 10.7 hours faster in the AXDX group [14.5 (4.9-31.3) SOC vs 25.2 (7.2-46.9) AXDX]
⁃ Time to first antibiotic de-escalation was significantly faster in the AXDX [27.6 h (13.2-44.0)] vs SOC [35.3 h (15.5-52.7); P=0.0032]
664 - Cedars-Sinai, UAMS, Allegheny Health, Iowa Hospitals & Clinics
Evaluating the impact of the Accelerate PhenoTest® BC Kit on patients with bloodstream infections receiving ineffective empirical antibiotic treatment: IOAS study experience of 4 hospitals
S. Macvane, A. Bhalodi, R. Humphries, B. Ford, et al.
From the data
⁃ Of 750 patients with BSI, 182 (24.3%) received IET [SOC: 82/377 (21.8%) vs. AXDX: 100/373 (26.8%); P=0.11]
⁃ Median time (hours) to effective therapy [SOC: 12.6 (2.7-37.1) vs. AXDX: 5.9 (2.9-13.6); P=0.027] was faster for patients in the AXDX group.
⁃ The percentage receiving effective antibiotic treatment at 24 hours following blood culture positivity was significantly higher in AXDX (83.0%) than in SOC (64.6%; P=0.005).
⁃ Among patients who received IET, 30-day mortality was lower in AXDX (6.0%; 6/100) than in SOC (15.9%; 13/82; P=0.03)
⁃ In patients who receive ineffective empirical antibiotic treatment for BSI, use of AXDX was associated with decreased time to effective therapy and 30-day mortality.
758 - UAMS, Iowa Hospitals & Clinics, Allegheny Health, Cedars-Sinai
Impact of the Accelerate PhenoTest® BC Kit on time to results for pathogens from bloodstream infections: IOAS (Improving Outcomes and Antibiotic Stewardship) study experience of 4 hospitals
A. Bhalodi, S. Macvane, R. Humphries, M. Morgan, et al.
From the data
⁃ Median times to blood culture positivity were similar in both groups [SOC 15.4 h (IQR, 13.0-21.6) vs. AXDX 15.1 h (12.9-19.4)]
⁃ Median time to ID in the SOC group was 26.6 h (14.8-37.8) and 2.5 h (2.1-2.9), p<0.0001 in the AXDX group
⁃ Median time to AST in the SOC group was 39.7 h (31.3-51.3) vs. 7.9 h (7.4-9.7), p<0.0001 in the AXDX group
⁃ AXDX provided significant reductions in time to ID and AST