Use of a rapid detection test for extended-spectrum betalactamase from direct blood culture: an antimicrobial stewardship tool in a tertiary hospital in Spain.
Introduction. Bacteremia caused by Gram-negative bacilli places a substantial burden on healthcare systems, mainly due to antibiotic resistance and delays in administering appropriate antimicrobial treatment (AT). The aim of this study was to describe the implementation of a rapid detection test (RD...
| Publicado en: | Revista Española de Quimioterapia Vol. 38; no. 2; pp. 84 - 97 |
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| Autores principales: | , , |
| Formato: | Artículo |
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Sociedad Espanola de Quimioterapia
abr2025
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| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=183826757&site=ehost-live header: @attributes: shortDbName: lth uiTerm: 183826757 longDbName: MedicLatina uiTag: AN controlInfo: bkinfo: jinfo: jid: 02143429 56RF jtl: Revista Española de Quimioterapia issn: 02143429 maglogo: N pubinfo: dt: abr2025 vid: 38 iid: 2 pid: 41363 pub: Sociedad Espanola de Quimioterapia artinfo: ui: 183826757 10.37201/req/108.2024 ppf: 84 ppct: 13 formats: fmt: @attributes: type: P size: 1.1MB tig: atl: Use of a rapid detection test for extended-spectrum betalactamase from direct blood culture: an antimicrobial stewardship tool in a tertiary hospital in Spain. aug: au: Rodríguez-Ayala, Montserrat Cacho-Calvo, Juana Cendejas-Bueno, Emilio affil: Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, Madrid, Spain. Department of Preventive Medicine, Public Health and Microbiology, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain. CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain. su: Electronic health records Antimicrobial stewardship Bacteremia Drug resistance in bacteria Gram-negative bacteria sug: subj: Electronic health records Antimicrobial stewardship Bacteremia Drug resistance in bacteria Gram-negative bacteria keyword: CTX-M ESBL Direct blood culture Enterobacterales bacteremia Rapid detection test Bacteriemia por Enterobacterales BLEE CTX-M Hemocultivo directo PROA Test de detección rápida ab: Introduction. Bacteremia caused by Gram-negative bacilli places a substantial burden on healthcare systems, mainly due to antibiotic resistance and delays in administering appropriate antimicrobial treatment (AT). The aim of this study was to describe the implementation of a rapid detection test (RDT) for CTX-M Extended Spectrum Beta-Lactamase-producing Enterobacterales (ESBL-PE) bacteremia as a tool for Antimicrobial Stewardship (AMS) in a tertiary hospital in Spain. Material and methods. A cross-sectional study was conducted on blood culture (BC) samples from adult patients (≥18 years) admitted to a tertiary hospital in Spain (January 2021-February 2024). BCs with confirmed Enterobacterales identification were included. An RDT was used to detect CTX-M ESBL from direct BC. The results were reported to the AMS team. Data from electronic medical records and our laboratory information system were analyzed to explore the utility of implementing an RDT as an AMS tool. Results. A total of 250 BCs from 250 patients were included. Empiric antimicrobial treatment (EAT) had not been prescribed in 41/250 (16.4%) patients, but was appropriately initiated in 33/250 (13.2%) after notification of the RDT results. Among those already receiving EAT (209/250, 83.6%), inappropriate and appropriate actions in AT were observed in 18/250 (7.2%) and 191/250 (76.4%) patients, respectively. By the time routine AST results were available, 241 (96.4%) patients had received appropriate treatment. Conclusions. This study demonstrated the real-world application of an RDT to detect CTX-M ESBL directly from BC in a tertiary hospital. Early reporting of CTX-M ESBL status in Enterobacterales bacteremia enabled physicians and AMS teams to optimize AT. Introducción. Las bacteriemias por bacilos gramnegativos suponen una carga considerable para los sistemas sanitarios, debido principalmente a la resistencia antibiótica y a los retrasos en la administración de un tratamiento antimicrobiano (TA) adecuado. El objetivo de este estudio fue describir la implementación de un test de detección rápida (TDR) para identificar bacteriemias por Enterobacterales productoras de betalactamasas de espectro extendido (BLEE) de tipo CTX-M como herramienta para los programas de optimización del uso de antimicrobianos (PROA) en un hospital terciario de España. Materiales y métodos. Se realizó un estudio transversal de muestras de hemocultivo de pacientes adultos (≥18 años) ingresados en un hospital terciario de España (enero 2021-febrero 2024). Se incluyeron hemocultivos con una identificación confirmada de microorganismos del orden Enterobacterales. Se utilizó un TDR para detectar BLEE CTX-M a partir de hemocultivo directo. Los resultados se comunicaron al equipo PROA de nuestro hospital. Se analizaron los datos de historias clínicas electrónicas y de nuestro sistema de información de laboratorio para explorar la utilidad de la implementación del TDR. Resultados. Se incluyeron 250 hemocultivos. En 41/250 (16,4%) pacientes no se había prescrito tratamiento antimicrobiano empírico (TAE), pero en 33/250 (13,2%) se inició adecuadamente tras la notificación de los resultados del TDR. Entre los que ya recibían TAE (209/250, 83,6%), se observaron acciones inapropiadas y apropiadas en el tratamiento en 18/250 (7,2%) y 191/25 (76,4%) pacientes, respectivamente. Tras disponer de los resultados de susceptibilidad antibiótica de rutina, 241 pacientes (96,4%) recibieron tratamiento adecuado. Conclusiones. Este estudio demostró la aplicación de un TDR para detectar BLEE CTX-M en muestras de hemocultivo directo en un hospital terciario. La notificación temprana de los resultados de un TDR permitió a los médicos y a los equipos PROA optimizar el tratamiento antibiótico. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y custom: Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. item: Revista Española de Quimioterapia holder: Sociedad Espanola de Quimioterapia dt: @attributes: year: 2025 holdings: @attributes: islocal: N |
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