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      Randomized Trial of Rapid Multiplex Polymerase Chain Reaction–Based Blood Culture Identification and Susceptibility Testing

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          Abstract

          The value of rapid, panel-based molecular diagnostics for positive blood culture bottles (BCBs) has not been rigorously assessed. We performed a prospective randomized controlled trial evaluating outcomes associated with rapid multiplex PCR (rmPCR) detection of bacteria, fungi, and resistance genes directly from positive BCBs.

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          Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship.

          Timothy H Dellit, Robert Owens, John E. McGowan … (2007)
          Article 0 comments Cited 813 times – based on 0 reviews     Review now
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            Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock*

            Anand Kumar, Daniel Roberts, Kenneth Wood … (2006)
            Critical Care Medicine, 34(6), 1589-1596
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              Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program.

              Ricard Ferrer, Ignacio Martin-Loeches, Gary Phillips … (2014)
              Compelling evidence has shown that aggressive resuscitation bundles, adequate source control, appropriate antibiotic therapy, and organ support are cornerstone for the success in the treatment of patients with sepsis. Delay in the initiation of appropriate antibiotic therapy has been recognized as a risk factor for mortality. To perform a retrospective analysis on the Surviving Sepsis Campaign database to evaluate the relationship between timing of antibiotic administration and mortality. Retrospective analysis of a large dataset collected prospectively for the Surviving Sepsis Campaign. One hundred sixty-five ICUs in Europe, the United States, and South America. A total of 28,150 patients with severe sepsis and septic shock, from January 2005 through February 2010, were evaluated. Antibiotic administration and hospital mortality. A total of 17,990 patients received antibiotics after sepsis identification and were included in the analysis. In-hospital mortality was 29.7% for the cohort as a whole. There was a statically significant increase in the probability of death associated with the number of hours of delay for first antibiotic administration. Hospital mortality adjusted for severity (sepsis severity score), ICU admission source (emergency department, ward, vs ICU), and geographic region increased steadily after 1 hour of time to antibiotic administration. Results were similar in patients with severe sepsis and septic shock, regardless of the number of organ failure. The results of the analysis of this large population of patients with severe sepsis and septic shock demonstrate that delay in first antibiotic administration was associated with increased in-hospital mortality. In addition, there was a linear increase in the risk of mortality for each hour delay in antibiotic administration. These results underscore the importance of early identification and treatment of septic patients in the hospital setting.
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                Author and article information

                Journal
                Title: Clinical Infectious Diseases
                Abbreviated Title: Clin Infect Dis.
                Publisher: Oxford University Press (OUP)
                ISSN (Print): 1058-4838
                ISSN (Electronic): 1537-6591
                Publication date Created: September 05 2015
                Publication date Created: October 01 2015
                Publication date (Print): October 01 2015
                Publication date (Electronic): July 20 2015
                Volume: 61
                Issue: 7
                Pages: 1071-1080
                Article
                DOI: 10.1093/cid/civ447
                PMC ID: 4560903
                PubMed ID: 26197846
                SO-VID: edab9c16-edd2-4d55-9fc5-9e98736b7a3e
                Copyright © © 2015
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