American Journal of Laboratory Medicine

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Clinical Outcomes with Implementation of Accelerate Pheno™ Blood Culture Detection System for Gram-Negative Bacteremia

Received: Jun. 30, 2023    Accepted: Jul. 25, 2023    Published: Aug. 04, 2023
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Abstract

Delayed treatment in bacteremia increases patient morbidity and healthcare costs. Accelerate Pheno™ Blood Culture Detection System (AXDX) is a novel diagnostic technology for the rapid detection of gram-negative bacteremia. Studies have shown accurate and faster time to speciation and sensitivity (TTSS) by AXDX compared to conventional modality. However, however, our study further examined the direct impact of AXDX on clinical outcomes and cost. Our retrospective study consisted of 178 patients at least 18 years old admitted to our academic medical institution with gram-negative bacteremia. The pre-AXDX group had 91 patients admitted in 2019 while the post-AXDX group had 87 patients admitted in 2021. Demographics, microbes, TTSS, time to de-escalation of therapy (TTDeT), length of stay (LOS), readmissions, and Clostridioides difficile infection (CDI) rates were recorded and differences between the cohorts were statistically analyzed. The pre-AXDX group had 51.32% females, mean age of 60.28 years, mean Charlson Co-morbidity Index (CCMI) of 2.23, mean LOS of 21.19 days, and mean Pitt-Bacteremia Score (PBS) of 2.35. The post-AXDX group had 51.92% females, mean age of 63.66 years, mean CCMI of 2.99, median LOS of 15.02 days, and mean PBS of 2.71. Both groups’ top two sources of bacteremia were urinary and gastrointestinal and the two most common microbes were Escherichia coli and Klebsiella pneumoniae. Pre-AXDX's mean TTSS was 70.95 hours and 62.92 hours for post-AXDX. Pre-AXDX's mean TTDeT was 73.90 hours and 43.85 hours for post-AXDX. The pre-AXDX cohort had 7.12% increase in related readmissions, 5.45% more CDI, and 0.26% increase in inpatient mortality. In addition to faster TTSS with AXDX as seen with previous studies, our study shows clinical advantages with AXDX use. While both groups were comparable in bacteremia sources and microbes. The post-AXDX group had higher CCMI and PBS scores, indicating they were more ill. Despite this, the pre-AXDX group had longer TTDeT by 30.05 hours, longer mean LOS by 6.17 days, 5.45% more CDI, 7.12% more readmissions, and 0.26% more mortality rates. The pre-AXDX group also reported adverse reactions to antibiotics while the post-AXDX had none. Our data shows AXDX use improves clinical outcomes with fewer adverse effects, mortality, and CDI rates and decreases cost with shorter LOS and lower readmission rates.

DOI 10.11648/j.ajlm.20230803.11
Published in American Journal of Laboratory Medicine ( Volume 8, Issue 3, May 2023 )
Page(s) 27-34
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Gram-Negative Bacteremia, Rapid Diagnostic Technology, Outcomes, Costs

References
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Cite This Article
  • APA Style

    Shu Xian Lee, Benita Yong Wu, Kurt Suter, Matthew Scott Lokant, Andrew Ward, et al. (2023). Clinical Outcomes with Implementation of Accelerate Pheno™ Blood Culture Detection System for Gram-Negative Bacteremia. American Journal of Laboratory Medicine, 8(3), 27-34. https://doi.org/10.11648/j.ajlm.20230803.11

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    Shu Xian Lee; Benita Yong Wu; Kurt Suter; Matthew Scott Lokant; Andrew Ward, et al. Clinical Outcomes with Implementation of Accelerate Pheno™ Blood Culture Detection System for Gram-Negative Bacteremia. Am. J. Lab. Med. 2023, 8(3), 27-34. doi: 10.11648/j.ajlm.20230803.11

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    AMA Style

    Shu Xian Lee, Benita Yong Wu, Kurt Suter, Matthew Scott Lokant, Andrew Ward, et al. Clinical Outcomes with Implementation of Accelerate Pheno™ Blood Culture Detection System for Gram-Negative Bacteremia. Am J Lab Med. 2023;8(3):27-34. doi: 10.11648/j.ajlm.20230803.11

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  • @article{10.11648/j.ajlm.20230803.11,
      author = {Shu Xian Lee and Benita Yong Wu and Kurt Suter and Matthew Scott Lokant and Andrew Ward and Amy Spigelmyer and Jesse Martin Thompson and Ryan Demkowicz and Catessa Howard and Paul Rocco LaSala and Rebecca Reece},
      title = {Clinical Outcomes with Implementation of Accelerate Pheno™ Blood Culture Detection System for Gram-Negative Bacteremia},
      journal = {American Journal of Laboratory Medicine},
      volume = {8},
      number = {3},
      pages = {27-34},
      doi = {10.11648/j.ajlm.20230803.11},
      url = {https://doi.org/10.11648/j.ajlm.20230803.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajlm.20230803.11},
      abstract = {Delayed treatment in bacteremia increases patient morbidity and healthcare costs. Accelerate Pheno™ Blood Culture Detection System (AXDX) is a novel diagnostic technology for the rapid detection of gram-negative bacteremia. Studies have shown accurate and faster time to speciation and sensitivity (TTSS) by AXDX compared to conventional modality. However, however, our study further examined the direct impact of AXDX on clinical outcomes and cost. Our retrospective study consisted of 178 patients at least 18 years old admitted to our academic medical institution with gram-negative bacteremia. The pre-AXDX group had 91 patients admitted in 2019 while the post-AXDX group had 87 patients admitted in 2021. Demographics, microbes, TTSS, time to de-escalation of therapy (TTDeT), length of stay (LOS), readmissions, and Clostridioides difficile infection (CDI) rates were recorded and differences between the cohorts were statistically analyzed. The pre-AXDX group had 51.32% females, mean age of 60.28 years, mean Charlson Co-morbidity Index (CCMI) of 2.23, mean LOS of 21.19 days, and mean Pitt-Bacteremia Score (PBS) of 2.35. The post-AXDX group had 51.92% females, mean age of 63.66 years, mean CCMI of 2.99, median LOS of 15.02 days, and mean PBS of 2.71. Both groups’ top two sources of bacteremia were urinary and gastrointestinal and the two most common microbes were Escherichia coli and Klebsiella pneumoniae. Pre-AXDX's mean TTSS was 70.95 hours and 62.92 hours for post-AXDX. Pre-AXDX's mean TTDeT was 73.90 hours and 43.85 hours for post-AXDX. The pre-AXDX cohort had 7.12% increase in related readmissions, 5.45% more CDI, and 0.26% increase in inpatient mortality. In addition to faster TTSS with AXDX as seen with previous studies, our study shows clinical advantages with AXDX use. While both groups were comparable in bacteremia sources and microbes. The post-AXDX group had higher CCMI and PBS scores, indicating they were more ill. Despite this, the pre-AXDX group had longer TTDeT by 30.05 hours, longer mean LOS by 6.17 days, 5.45% more CDI, 7.12% more readmissions, and 0.26% more mortality rates. The pre-AXDX group also reported adverse reactions to antibiotics while the post-AXDX had none. Our data shows AXDX use improves clinical outcomes with fewer adverse effects, mortality, and CDI rates and decreases cost with shorter LOS and lower readmission rates.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Clinical Outcomes with Implementation of Accelerate Pheno™ Blood Culture Detection System for Gram-Negative Bacteremia
    AU  - Shu Xian Lee
    AU  - Benita Yong Wu
    AU  - Kurt Suter
    AU  - Matthew Scott Lokant
    AU  - Andrew Ward
    AU  - Amy Spigelmyer
    AU  - Jesse Martin Thompson
    AU  - Ryan Demkowicz
    AU  - Catessa Howard
    AU  - Paul Rocco LaSala
    AU  - Rebecca Reece
    Y1  - 2023/08/04
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ajlm.20230803.11
    DO  - 10.11648/j.ajlm.20230803.11
    T2  - American Journal of Laboratory Medicine
    JF  - American Journal of Laboratory Medicine
    JO  - American Journal of Laboratory Medicine
    SP  - 27
    EP  - 34
    PB  - Science Publishing Group
    SN  - 2575-386X
    UR  - https://doi.org/10.11648/j.ajlm.20230803.11
    AB  - Delayed treatment in bacteremia increases patient morbidity and healthcare costs. Accelerate Pheno™ Blood Culture Detection System (AXDX) is a novel diagnostic technology for the rapid detection of gram-negative bacteremia. Studies have shown accurate and faster time to speciation and sensitivity (TTSS) by AXDX compared to conventional modality. However, however, our study further examined the direct impact of AXDX on clinical outcomes and cost. Our retrospective study consisted of 178 patients at least 18 years old admitted to our academic medical institution with gram-negative bacteremia. The pre-AXDX group had 91 patients admitted in 2019 while the post-AXDX group had 87 patients admitted in 2021. Demographics, microbes, TTSS, time to de-escalation of therapy (TTDeT), length of stay (LOS), readmissions, and Clostridioides difficile infection (CDI) rates were recorded and differences between the cohorts were statistically analyzed. The pre-AXDX group had 51.32% females, mean age of 60.28 years, mean Charlson Co-morbidity Index (CCMI) of 2.23, mean LOS of 21.19 days, and mean Pitt-Bacteremia Score (PBS) of 2.35. The post-AXDX group had 51.92% females, mean age of 63.66 years, mean CCMI of 2.99, median LOS of 15.02 days, and mean PBS of 2.71. Both groups’ top two sources of bacteremia were urinary and gastrointestinal and the two most common microbes were Escherichia coli and Klebsiella pneumoniae. Pre-AXDX's mean TTSS was 70.95 hours and 62.92 hours for post-AXDX. Pre-AXDX's mean TTDeT was 73.90 hours and 43.85 hours for post-AXDX. The pre-AXDX cohort had 7.12% increase in related readmissions, 5.45% more CDI, and 0.26% increase in inpatient mortality. In addition to faster TTSS with AXDX as seen with previous studies, our study shows clinical advantages with AXDX use. While both groups were comparable in bacteremia sources and microbes. The post-AXDX group had higher CCMI and PBS scores, indicating they were more ill. Despite this, the pre-AXDX group had longer TTDeT by 30.05 hours, longer mean LOS by 6.17 days, 5.45% more CDI, 7.12% more readmissions, and 0.26% more mortality rates. The pre-AXDX group also reported adverse reactions to antibiotics while the post-AXDX had none. Our data shows AXDX use improves clinical outcomes with fewer adverse effects, mortality, and CDI rates and decreases cost with shorter LOS and lower readmission rates.
    VL  - 8
    IS  - 3
    ER  - 

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Author Information
  • Department of Medicine, West Virginia University, Morgantown, USA

  • Department of Medicine, West Virginia University, Morgantown, USA

  • Department of Medicine, West Virginia University, Morgantown, USA

  • Department of Medicine, Vanderbilt University, Nashville, USA

  • School of Pharmacy, West Virginia University, Morgantown, USA

  • School of Pharmacy, West Virginia University, Morgantown, USA

  • School of Medicine, West Virginia University, Morgantown, USA

  • Department of Pathology, West Virginia University, Morgantown, USA

  • School of Pharmacy, West Virginia University, Morgantown, USA

  • Department of Pathology, West Virginia University, Morgantown, USA

  • Department of Medicine, West Virginia University, Morgantown, USA

  • Section