Influence of GeneXpert MRSA/SA test implementation on clinical outcomes of Staphylococcus aureus bacteremia — a before–after retrospective study

Ben‐Zvi, Haim; Drozdinsky, Genady; Kushnir, Shiri; Avni, Tomer; Scheuerman, Oded; Bisahra, Jihad; Yahav, Dafna

doi:10.1016/j.diagmicrobio.2018.08.011

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…110 Combined Culture-and Nonculture-Based Technologies A technique combining nucleic acid purification and real-time PCR detection facilitates a range of detection capabilities for viruses and bacteria (including Mycobacteria), 111 can detect AMR, and again has shown good performance against reference tests. [112][113][114][115] It can be used on positive blood cultures to shorten time to identification of pathogens and their resistance profiles, and has nonculture-based applications also. 4,116 Results take from around 50 minutes to 2 hours.…”

Section: Culture-based Technologiesmentioning

confidence: 99%

Management of Multidrug-Resistant Infections in Cirrhosis

Gallaher

Shawcross

2022

Semin Liver Dis

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The World Health Organization describes antimicrobial resistance (AMR) as one of the biggest threats to global health, food security, and development with indiscriminate use of antimicrobials globally driving the emergence of multidrug-resistant bacteria, resistant to 60% of antimicrobials in some countries. Infections with multi-drug resistant organisms (MDROs) have increased in recent decades in patients with cirrhosis, who are frequently prescribed antibiotics, regularly undergo invasive procedures such as large volume paracentesis and have recurrent hospitalizations, posing a particular risk in this already immunocompromised cohort of patients. In this review, we explore mechanisms underlying this vulnerability to MDRO infection; the effect of bacterial infections on disease course in cirrhosis; prevalence of MDROs in patients with cirrhosis; outcomes following MDRO infection; fungal infections; antibiotics and their efficacy; and management of MDRO infections in terms of detection, antimicrobial and non-antimicrobial treatments, prophylaxis, antibiotic stewardship, the gut microbiome, and technological interventions.

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Section: Culture-based Technologiesmentioning

confidence: 99%

Management of Multidrug-Resistant Infections in Cirrhosis

Gallaher

Shawcross

2022

Semin Liver Dis

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“…75 Multiple studies have examined the impact of MRSA/SA SSTI kit on the GeneXpert platform, a rapid (1 hour) automated PCR assay on duration of MRSA covering therapy vs traditional culture methods. [51][52][53] These studies all added this intervention to their routine ASP functions and no other interventions were performed at the time. Gritte and colleagues, 52 noted the intervention resulted in a decrease in time to effective therapy, but only a non-statistically significant decrease in vancomycin days (3.0 days vs 1.0 days, P = .323), which maybe at least partially related to the increased MRSA isolated in the post-intervention period.…”

Section: Rapid Testingmentioning

confidence: 99%

Approaches to Reduce Use and Duration of Anti-MRSA Agents for Antimicrobial Stewardship Programs: A Review of Recent Literature

Wang

Girotto

2022

Journal of Pharmacy Practice

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Antimicrobial stewardship programs (ASPs) have the potential to effectively deescalate unnecessary methicillin-resistant Staphylococcus aureus (MRSA) coverage. This review summarizes literature published from 2014 through 2021 describing contemporary ASP methods and their resulting effectiveness at reducing anti-MRSA agent use (ie vancomycin, linezolid, daptomycin, ceftaroline, and clindamycin). This review of the literature examined the following strategies, which had reports of success in either decreasing the use or duration of anti-MRSA agents: prospective review and feedback, antibiotic timeouts, health system or department protocol changes, polymerase chain reaction (PCR) and rapid testing of patient samples. Most of the current literature continue to support most ASP interventions including antibiotic timeouts, pathways, and molecular testing including MRSA nasal PCRs and rapid diagnostic testing can be successful at reducing unnecessary anti-MRSA use.

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“…However, low detection rates, long turn‐around times, and prone to contamination render it insufficient to meet the demand for early and/or rapid clinical diagnosis 9 . With continued development in molecular biotechnologies, numerous nucleic acid detection technologies for the diagnosis of BSI have emerged, such as fluorescence in situ hybridization (FISH), microarray gene chips, nested multiplex PCR, and quantitative real‐time PCR (qRT‐PCR) 10–14 …”

Section: Introductionmentioning

confidence: 99%

“…9 With continued development in molecular biotechnologies, numerous nucleic acid detection technologies for the diagnosis of BSI have emerged, such as fluorescence in situ hybridization (FISH), microarray gene chips, nested multiplex PCR, and quantitative real-time PCR (qRT-PCR). [10][11][12][13][14] Multiplex PCR has been widely used in a variety of fields of genetic testing and showed higher detection efficiency and lower cost compared to conventional PCR. [15][16][17] However, at least two shortcomings remain.…”

Section: Introductionmentioning

confidence: 99%

Developing a multiplex PCR‐based assay kit for bloodstream infection by analyzing genomic big data

Zhang

Luo²,

Zeng³

et al. 2022

Clinical Laboratory Analysis

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Background In recent years, the incidence of bloodstream infections (BSI) has increased, the composition of pathogenic bacteria has changed, and drug resistance among bacteria has gradually increased due to the widespread use of interventional techniques, broad‐spectrum antibacterial drugs, hormones, and immunosuppressive agents. Here, we have developed a multiplex PCR assay kit for the detection of pathogens (14 Gram‐negative bacteria, 15 Gram‐positive bacteria, and 4 fungi) in whole blood from patients with BSI using five‐color fluorescent multiplex PCR followed by capillary electrophoresis. Our assay exhibits a diagnosis of higher quality and an improved detection rate for common pathogens. Methods A local genome DNA database of 33 pathogenic bacteria was constructed. Next, “Exhaustive” primer search of the full coding sequence of the reference genomes of these bacteria was performed. Panels with minimal interactions between primers and amplicons were selected by random sampling and testing by a recursive algorithm. Primers and Mg2+ concentrations and PCR reaction procedures were optimized to maximize the detection efficacy. Results The LOD of the kit was determined as 100 copies/μl. Using clinical samples, results generated by this kit and regular blood culture method were found to be 95.08% consistent. Additionally, six pathogens which were unidentifiable by blood culture were successfully detected by this kit. Conclusion Our study provided a bioinformatics approach to the challenge of primer design in multiplex PCR, and combined with optimized wet lab practice, a multiplex PCR‐based assay kit for BSI with higher sensitivity and accuracy than blood culture was produced.

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Influence of GeneXpert MRSA/SA test implementation on clinical outcomes of Staphylococcus aureus bacteremia — a before–after retrospective study

Cited by 10 publications

References 22 publications

Management of Multidrug-Resistant Infections in Cirrhosis

Management of Multidrug-Resistant Infections in Cirrhosis

Approaches to Reduce Use and Duration of Anti-MRSA Agents for Antimicrobial Stewardship Programs: A Review of Recent Literature

Developing a multiplex PCR‐based assay kit for bloodstream infection by analyzing genomic big data

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