Impact of rapid in situ hybridization testing on coagulase-negative staphylococci positive blood cultures

Forrest, Graeme N.; Mehta, Sanjay; Weekes, Elizabeth; Lincalis, Durry P; Johnson, J. Kristie; Venezia, Richard A.

doi:10.1093/jac/dkl146

Cited by 165 publications

(125 citation statements)

References 20 publications

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“…85 CDSSs can take many forms, including comprehensive computerized disease management systems that can integrate clinical data, medication orders, and laboratory and microbiology results to suggest anti-infective therapy and alert clinicians about potential suboptimal management of infections. [86][87][88][89] Several studies of rapid blood culture diagnostics report favorable outcomes when rapid test results are reported together with CDSSs that provide actionable guidance for clinicians through antimicrobial stewardship team oversight [90][91][92][93][94][95][96][97] or even templated comments contained within the result report. 84 Increasingly, electronic health records platforms such as Epic and Cerner are incorporating CDSSs to enhance antimicrobial stewardship.…”

Section: Treatment Implications Of Rapid Detection Of Crementioning

confidence: 99%

Clinical and laboratory considerations for the rapid detection of carbapenem-resistant Enterobacteriaceae

Banerjee

Humphries

2016

Virulence

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Carbapenem resistance among the Enterobacteriaceae has become a significant clinical and public health dilemma. Rapid administration of effective antimicrobials and implementation of supplemental infection control practices is required to both improve patient outcomes and limit the spread of these highly resistant organisms. However, carbapenem-resistant Enterobacteriaceae (CRE)-infected patients are predominantly identified by routine culture methods, which take days to perform. Rapid genomic and phenotypic methods are currently available to accelerate the identification of carbapenemaseproducing CRE. Effective use of these technologies is reliant on close collaboration between clinical microbiology, infection prevention, antimicrobial stewardship and infectious diseases specialists. This review discusses the performance characteristics of these technologies to date, and describes strategies for their optimal implementation.

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Section: Treatment Implications Of Rapid Detection Of Crementioning

confidence: 99%

Clinical and laboratory considerations for the rapid detection of carbapenem-resistant Enterobacteriaceae

Banerjee

Humphries

2016

Virulence

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“…Several microbial diagnostic methods such as real-time polymerase chain reaction (RT-PCR), target enriched multiplex polymerase chain reaction (Tem-PCR), and gene microarray have been described in literature, but only peptide nucleic acid fluorescent in-situ hybridization (PNA FISH) has published data justifying its use based on clinical outcomes and associated cost savings [9][10][11]. In general, all of these methods identify and differentiate pathogens on a genotypic, rather than phenotypic, basis by detecting species specific expressed gene products directly from blood samples.…”

Section: Overview Of Currently Available Rapid Microbiological and Momentioning

confidence: 99%

“…A retrospective, cost-effectiveness analysis done by Forrest et al in 2006 evaluated the impact of rapid differentiation of Staphylococcus aureus from coagulase-negative staphylococci (CoNS) with PNA FISH in blood culture samples positive for gram-positive cocci in clusters (GPCC) [9]. Vancomycin usage, length of hospital stay, and hospital costs were evaluated.…”

Section: Impact Of Rapid Microbiological and Molecular Techniquesmentioning

confidence: 99%

The Utility of Rapid Microbiological and Molecular Techniques in Optimizing Antimicrobial Therapy

Eiland

Beyda

Han³

et al. 2010

SRX Pharmacology

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Early treatment of bloodstream infections with appropriate, definitive antimicrobial therapy has proven to reduce mortality, length of hospital stay, and healthcare costs. Culture-based testing methods require up to five days for final pathogen identification and susceptibility reporting, forcing use of broad spectrum empiric therapy. Recently, multiple rapid microbiological and molecular testing methods have been developed that reduce the time to identify the pathogen and susceptibility, allowing optimal antimicrobial therapy to be prescribed earlier. Real-time polymerase chain reaction and gene microarray have been described in literature, yet only peptide nucleic acid fluorescent in-situ hybridization has published data justifying its use based on clinical outcomes and cost savings. Target enriched multiplex polymerase chain reaction was developed to identify both the pathogen and multiple genes associated with resistance from blood within 6 hours and this methodology was studied in our hospital to assess effectiveness at optimizing antimicrobials in staphylococcal bloodstream infections.

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“…107 The main strength of the assay is the quick procedure that enables a targeted and shorter therapy, increases benefits for patients, and reduces health care costs. 108 The reverse blot hybridization assay (REBA) is a molecular tool that uses multiple probes for the detection and the simultaneous identification of Gram-positive and Gram-negative pathogens, and mecA and van genes from BC. Therefore, the REBA test may be able to detect nonviable bacteria or those at a low concentration that are not detectable by BC.…”

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confidence: 99%

In vitro diagnosis of sepsis: a review

Marcello

Tumolo²,

Donno³

et al. 2016

PLMI

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Sepsis, severe sepsis and septic shock, systemic inflammatory response, and other related manifestations represent a relevant medical problem with high morbidity and mortality, despite the improvements in diagnosis, treatment, and preventive measures over the last few decades. The limited knowledge of the pathophysiology in association with the lack of in vitro diagnostic methods for the certain and quick determination of the causative microbiological agents and their antibiotic resistance means the condition is still critical and of high impact in health care. The current gold standard method to detect the sepsis-causing pathogens, which is based on blood culture, is still insufficiently sensitive and slow. The new culture-independent molecular biology-based techniques can lead to the identification of a broad range of microorganisms and resistance markers within a few hours and with high sensitivity and specificity; nevertheless, limitations of, for example, the polymerase chain reaction-based methods still hamper their application in the clinical routine. This review summarizes the in vitro diagnostic methods and their approach in the clinical diagnosis of the bloodstream infections, and explores their advantages and disadvantages at the current state of the art. A quick analysis of the future prospective in multiplex technologies for microbiological diagnosis of sepsis is also provided.

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Impact of rapid in situ hybridization testing on coagulase-negative staphylococci positive blood cultures

Abstract: The PNA FISH assay is rapid, accurate and reliable and in association with an AMT could decrease hospital length of stay in patients with CoNS bacteraemia in non-intensive care unit settings and prevent excessive vancomycin usage.

Cited by 165 publications

References 20 publications

Clinical and laboratory considerations for the rapid detection of carbapenem-resistant Enterobacteriaceae

Clinical and laboratory considerations for the rapid detection of carbapenem-resistant Enterobacteriaceae

The Utility of Rapid Microbiological and Molecular Techniques in Optimizing Antimicrobial Therapy

In vitro diagnosis of sepsis: a review

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