No beneficial impact of shortened microbiological procedures for either hospitalized patients overall or for patients with bacteraemia
Abstract number: p983
Bruins M.J., Oord H.C.A., Bloembergen P., Wolfhagen M.J.H.M., Casparie A.F., Degener J.E., Ruijs G.J.H.M.
Shortening the turnaround time of microbiological procedures by using an automated system for bacterial identification and susceptibility testing is associated with an improved clinical outcome and a reduction of hospital cost, according to two American studies. We investigated whether the same beneficial effects could be reported for patients in a hospital in the Netherlands by conducting a single blind, randomized controlled trial.
Patients hospitalized in the Isala klinieken in Zwolle, the Netherlands, with a bacterial infection confirmed by culture were randomly assigned to a control or to an intervention (rapid) group. As is customary practice, the clinical microbiologists orally reported clinically relevant information to the clinician for all patients. For all patients complete culture results were reported on paper. For identification and susceptibility testing overnight methods were used in the control group. In the rapid group the Vitek 2 system (bioMérieux, Marcy l'Etoile, France) was used. In each of the three consecutive study periods accelerating factors were added in a step-up manner to the laboratory workflow of the rapid group, such as increasing oral reporting, extending the working day and adding an extra hard-copy report delivery. The workflow for the control group remained identical throughout the study. We analysed whether the turnaround time to reporting was shortened by using the Vitek 2 system and additional factors, and assessed the effects of a shortened turnaround time in terms of mortality, morbidity and cost for (i) the overall patient group and (ii) a subgroup of patients with bacteraemia
For the overall patient group (n = 1870), the time interval to oral reporting of final susceptibility results was significantly shorter for the rapid groups in all three-study periods, the time to reporting on paper was significantly shorter in the third period. For the subgroup of patients with bacteraemia (n = 183) a similar shortening of turnaround times was found. For neither the overall patient group nor the subgroup a significant difference in any of the clinical impact variables or a cost reduction was found.
Although the turnaround time to reporting of microbiology results was shortened significantly for both the overall patient group and the subgroup of bacteraemic patients, in our hospital setting no clinical impact or cost reduction could be reported as a result.
|Session name:||XXIst ISTH Congress|
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