title: Clinical and economic impact of antimicrobial stewardship interventions with the FilmArray blood culture identification panel.
abstract: The purpose of this study was to evaluate the impact of the FilmArray Blood Culture Identification (BCID) Panel on the management of patients with blood cultures growing gram positive cocci and Candida. We retrospectively compared clinical and economic outcomes between patients during the BCID testing period and a matched historical control group before BCID testing was introduced. A total of 84 BCID patients were matched to 252 historical controls. BCID identification of coagulase negative staphylococci contaminants resulted in shorter post-culture length of stay (P < 0.008) and saved roughly $30,000 per 100 patients tested. The BCID led to shorter duration of empirical vancomycin for patients with contaminated blood cultures (P = 0.005) and methicillin-susceptible Staphylococcus aureus bacteremia (P < 0.001). Patients with vancomycin-resistant enterococcal bacteremia received active therapy earlier than historical controls (P = 0.047). The BCID, coupled with antimicrobial stewardship intervention, was a cost effective tool to improve patient care.
authors.affiliation: Department of Pharmacy, UF Health Shands Hospital, 1600 SW Archer Road, Gainesville, FL 32608, USA. Electronic address: joseph.pardo@va.gov.
authors.forename: Joe
authors.initials: J
authors.lastname: Pardo
authors.affiliation: Department of Pharmacy, UF Health Shands Hospital, 1600 SW Archer Road, Gainesville, FL 32608, USA.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Klinker
authors.affiliation: Department of Pharmacy, UF Health Shands Hospital, 1600 SW Archer Road, Gainesville, FL 32608, USA.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Borgert
authors.affiliation: Department of Pathology, Immunology and Laboratory Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32603, USA.
authors.forename: Brittany M
authors.initials: BM
authors.lastname: Butler
authors.affiliation: UF Health Shands Hospital Clinical Microbiology Laboratory, 1600 SW Archer Road, Gainesville, FL 32608, USA.
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Giglio
authors.affiliation: Department of Pathology, Immunology and Laboratory Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32603, USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Rand
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D001769:Blood / Q000382:microbiology*; D003365:Costs and Cost Analysis; D004363:Drug Utilization / Q000191:economics / Q000592:standards*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000191:economics / Q000379:methods*; D065228:Non-Randomized Controlled Trials as Topic; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial stewardship; Bloodstream infection; Molecular diagnostics