Author, as appears in the article.: Rodriguez, A; Gomez, F; Sarvise, C; Gutierrez, C; Giralt, MG; Guerrero-Torres, MD; Pardo-Granell, S; Pico-Plana, E; Benavent-Bofill, C; Trefler, S; Berrueta, J; Canadell, L; Claverias, L; Pitarch, EE; Olona, M; Pardo, GG; Teixido, X; Bordonado, L; Sans, MT; Bodi, M; Blasi, FB
Department: Ciències Mèdiques Bàsiques Medicina i Cirurgia
URV's Author/s: Bodi Saera, Maria Amparo / Canadell Vilarrasa, Laura / Garcia Pardo, Graciano / Gomez Bertomeu, Frederic-Francesc / Olona Cabases, Maria Montserrat / Rodríguez Oviedo, Alejandro Hugo / TREFLER CRESPO, SANDRA INES
Keywords: Ventilator-associated pneumonia Rapid microbiological diagnostic techniques Nosocomial infection Infections Filmarrays Defined daily dose Antimicrobial consumption ventilator-associated pneumonia rapid microbiological diagnostic techniques filmarrays defined daily dose antimicrobial consumption
Abstract: Background: Data on the benefits of rapid microbiological testing on antimicrobial consumption (AC) and antimicrobial resistance patterns (ARPs) are scarce. We evaluated the impact of a protocol based on rapid techniques on AC and ARP in intensive care (ICU) patients. Methods: A retrospective pre- (2018) and post-intervention (2019–2021) study was conducted in ICU patients. A rapid diagnostic algorithm was applied starting in 2019 in patients with a lower respiratory tract infection. The incidence of nosocomial infections, ARPs, and AC as DDDs (defined daily doses) were monitored. Results: A total of 3635 patients were included: 987 in the pre-intervention group and 2648 in the post-intervention group. The median age was 60 years, the sample was 64% male, and the average APACHE II and SOFA scores were 19 points and 3 points. The overall ICU mortality was 17.2% without any differences between the groups. An increase in the number of infections was observed in the post-intervention group (44.5% vs. 17.9%, p < 0.01), especially due to an increase in the incidence of ventilator-associated pneumonia (44.6% vs. 25%, p < 0.001). AC decreased from 128.7 DDD in 2018 to 66.0 DDD in 2021 (rate ratio = 0.51). An increase in Pseudomonas aeruginosa susceptibility of 23% for Piperacillin/tazobactam and 31% for Meropenem was observed. Conclusion: The implementation of an algorithm based on rapid microbiological diagnostic techniques allowed for a significant reduction in AC and ARPs without affecting the prognosis of critically ill patients.
Thematic Areas: Pharmacology & pharmacy Medicine, research & experimental Medicine (miscellaneous) General biochemistry,genetics and molecular biology Ciencias sociales Biochemistry, genetics and molecular biology (miscellaneous) Biochemistry, genetics and molecular biology (all) Biochemistry & molecular biology
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: graciano.garcia@urv.cat alejandrohugo.rodriguez@urv.cat mariamontserrat.olona@urv.cat laura.canadell@urv.cat frederic-francesc.gomez@urv.cat mariaamparo.bodi@urv.cat mariaamparo.bodi@urv.cat
Author identifier: 0000-0001-8828-5984 0000-0002-8039-2889 0000-0001-7652-8379 0000-0001-7652-8379
Record's date: 2024-03-12
Papper version: info:eu-repo/semantics/publishedVersion
Papper original source: Biomedicines. 11 (12):
APA: Rodriguez, A; Gomez, F; Sarvise, C; Gutierrez, C; Giralt, MG; Guerrero-Torres, MD; Pardo-Granell, S; Pico-Plana, E; Benavent-Bofill, C; Trefler, S; Be (2023). Clinical and Microbiological Impact of Implementing a Decision Support Algorithm through Microbiologic Rapid Diagnosis in Critically Ill Patients: An Epidemiological Retrospective Pre-/Post-Intervention Study. Biomedicines, 11(12), -. DOI: 10.3390/biomedicines11123330
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Entity: Universitat Rovira i Virgili
Journal publication year: 2023
Publication Type: Journal Publications
Repositori URV