title: Impact of rapid identification of Acinetobacter Baumannii via matrix-assisted laser desorption ionization time-of-flight mass spectrometry combined with antimicrobial stewardship in patients with pneumonia and/or bacteremia.
abstract: We evaluated the clinical and economic outcomes of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) with stewardship intervention in patients with Acinetobacter baumannii (AB) pneumonia and/or bacteremia. 66 patients were included in the pre-intervention group and 53 in the intervention group. The combination of AB identification via MALDI-TOF MS and ID PharmD intervention significantly reduced the median time to effective therapy compared to conventional identification without intervention [77.7 (95% CI: 73.1-84.8) to 36.6 (95% CI: 25.9-50.9) hours (P < 0.0001)]. Rapid organism identification along with ID PharmD intervention was also associated with a 19% increase in clinical cure (15% versus 34%, P = 0.016) and a decreased length of stay during antibiotic therapy (13 [8-18] versus 11 [7-15] days, P = 0.021). No difference in 14-day mortality was observed (20% versus 25%, P = 0.526). Median costs during infection were approximately $6500 less in the intervention group ($49,402 [35,307-86,566] versus $42,872 [26,966-74,506]; P = 0.243). AB identification via MALDI-TOF MS combined with stewardship intervention allows for timely, effective antimicrobial therapy and is associated with increased clinical cure.
authors.affiliation: Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Wenzler
authors.affiliation: Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: debbie.goff@osumc.edu.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Goff
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Mangino
authors.affiliation: Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Erica E
authors.initials: EE
authors.lastname: Reed
authors.affiliation: Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Wehr
authors.affiliation: Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: Karri.Bauer@osumc.edu.
authors.forename: Karri A
authors.initials: KA
authors.lastname: Bauer
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D001431:Bacteriological Techniques / Q000379:methods; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004363:Drug Utilization / Q000592:standards; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D012189:Retrospective Studies; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acinetobacter baumannii; Antimicrobial stewardship; Bacteremia; MALDI-TOF MS; Pneumonia