Rapid diagnostic test and use of antibiotic against methicillin-resistant Staphylococcus aureus in adult intensive care unit
Ventilator-associated pneumonia (VAP) due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with excess mortality and costs. Molecular biology test allows rapid identification of MRSA in sputum with high negative predictive value. We hypothesized that use of a rapid diagnostic test...
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| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2017-02, Vol.36 (2), p.267-272 |
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| creator | Dureau, A.-F. Duclos, G. Antonini, F. Boumaza, D. Cassir, N. Alingrin, J. Vigne, C. Hammad, E. Zieleskiewicz, L. Leone, M. |
| description | Ventilator-associated pneumonia (VAP) due to methicillin-resistant
Staphylococcus aureus
(MRSA) is associated with excess mortality and costs. Molecular biology test allows rapid identification of MRSA in sputum with high negative predictive value. We hypothesized that use of a rapid diagnostic test in patients with suspected VAP was associated with reduced use of antibiotics directed against MRSA. This retrospective, observational study was conducted in a polyvalent intensive care unit (ICU) of a university hospital. We compared two periods: before (2007–2010) and after (2010–2015) the implementation of a rapid diagnostic test, which uses RT-PCR to detect pathogens in 60 minutes. The primary endpoint was the effect on the empirical use of anti-MRSA antibiotics. The second endpoint was the effect of this strategy on the cost regarding antibiotic treatment. The first group included 120 suspected VAP (88 patients) and the second group 121 suspected VAP (89 patients). Empirical use of vancomycin and linezolid decreased by 50 % between the two periods. Twenty-seven VAP (22 %) were treated with an anti-MRSA treatment between 2007 and 2010, and 13 (11 %) between 2010 and 2015 (
p
= 0.04). The mean cost of anti-MRSA treatment by patients in the first group was 63 ± 223 €, and 13 ± 52 € in the second group (
p
|
| doi_str_mv | 10.1007/s10096-016-2795-5 |
| format | Article |
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Staphylococcus aureus
(MRSA) is associated with excess mortality and costs. Molecular biology test allows rapid identification of MRSA in sputum with high negative predictive value. We hypothesized that use of a rapid diagnostic test in patients with suspected VAP was associated with reduced use of antibiotics directed against MRSA. This retrospective, observational study was conducted in a polyvalent intensive care unit (ICU) of a university hospital. We compared two periods: before (2007–2010) and after (2010–2015) the implementation of a rapid diagnostic test, which uses RT-PCR to detect pathogens in 60 minutes. The primary endpoint was the effect on the empirical use of anti-MRSA antibiotics. The second endpoint was the effect of this strategy on the cost regarding antibiotic treatment. The first group included 120 suspected VAP (88 patients) and the second group 121 suspected VAP (89 patients). Empirical use of vancomycin and linezolid decreased by 50 % between the two periods. Twenty-seven VAP (22 %) were treated with an anti-MRSA treatment between 2007 and 2010, and 13 (11 %) between 2010 and 2015 (
p
= 0.04). The mean cost of anti-MRSA treatment by patients in the first group was 63 ± 223 €, and 13 ± 52 € in the second group (
p
< 0.001). This study shows that a rapid diagnostic test was associated with reduced use and cost of anti-MRSA antibiotics in patients with suspected VAP. These results should be confirmed by further multicenter prospective studies.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-016-2795-5</identifier><identifier>PMID: 27714594</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Biomedical and Life Sciences ; Biomedicine ; Diagnostic tests ; Drug Utilization ; Hospitals, University ; Human health and pathology ; Humans ; Infectious diseases ; Intensive care ; Intensive Care Units ; Internal Medicine ; Life Sciences ; Medical Microbiology ; Methicillin-Resistant Staphylococcus aureus - isolation & purification ; Molecular biology ; Molecular Diagnostic Techniques - methods ; Mortality ; Observational studies ; Original Article ; Pneumonia ; Pneumonia, Ventilator-Associated - diagnosis ; Pneumonia, Ventilator-Associated - drug therapy ; Pneumonia, Ventilator-Associated - microbiology ; Prospective Studies ; Public health ; Real-Time Polymerase Chain Reaction - methods ; Retrospective Studies ; Sepsis ; Staphylococcal Infections - diagnosis ; Staphylococcal Infections - drug therapy ; Staphylococcal Infections - microbiology ; Staphylococcus aureus ; Staphylococcus infections ; Thoracic surgery ; Time Factors ; Ventilators</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2017-02, Vol.36 (2), p.267-272</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>European Journal of Clinical Microbiology & Infectious Diseases is a copyright of Springer, 2017.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-4b3411b610c3506abb5b4ab5f0cc996e6d8aca74d97a4371d6cf73da09ff07aa3</citedby><cites>FETCH-LOGICAL-c439t-4b3411b610c3506abb5b4ab5f0cc996e6d8aca74d97a4371d6cf73da09ff07aa3</cites><orcidid>0000-0002-0788-4967</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10096-016-2795-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10096-016-2795-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,778,782,883,27913,27914,41477,42546,51308</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27714594$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-01489506$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Dureau, A.-F.</creatorcontrib><creatorcontrib>Duclos, G.</creatorcontrib><creatorcontrib>Antonini, F.</creatorcontrib><creatorcontrib>Boumaza, D.</creatorcontrib><creatorcontrib>Cassir, N.</creatorcontrib><creatorcontrib>Alingrin, J.</creatorcontrib><creatorcontrib>Vigne, C.</creatorcontrib><creatorcontrib>Hammad, E.</creatorcontrib><creatorcontrib>Zieleskiewicz, L.</creatorcontrib><creatorcontrib>Leone, M.</creatorcontrib><title>Rapid diagnostic test and use of antibiotic against methicillin-resistant Staphylococcus aureus in adult intensive care unit</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>Ventilator-associated pneumonia (VAP) due to methicillin-resistant
Staphylococcus aureus
(MRSA) is associated with excess mortality and costs. Molecular biology test allows rapid identification of MRSA in sputum with high negative predictive value. We hypothesized that use of a rapid diagnostic test in patients with suspected VAP was associated with reduced use of antibiotics directed against MRSA. This retrospective, observational study was conducted in a polyvalent intensive care unit (ICU) of a university hospital. We compared two periods: before (2007–2010) and after (2010–2015) the implementation of a rapid diagnostic test, which uses RT-PCR to detect pathogens in 60 minutes. The primary endpoint was the effect on the empirical use of anti-MRSA antibiotics. The second endpoint was the effect of this strategy on the cost regarding antibiotic treatment. The first group included 120 suspected VAP (88 patients) and the second group 121 suspected VAP (89 patients). Empirical use of vancomycin and linezolid decreased by 50 % between the two periods. Twenty-seven VAP (22 %) were treated with an anti-MRSA treatment between 2007 and 2010, and 13 (11 %) between 2010 and 2015 (
p
= 0.04). The mean cost of anti-MRSA treatment by patients in the first group was 63 ± 223 €, and 13 ± 52 € in the second group (
p
< 0.001). This study shows that a rapid diagnostic test was associated with reduced use and cost of anti-MRSA antibiotics in patients with suspected VAP. These results should be confirmed by further multicenter prospective studies.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Diagnostic tests</subject><subject>Drug Utilization</subject><subject>Hospitals, University</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Internal Medicine</subject><subject>Life Sciences</subject><subject>Medical Microbiology</subject><subject>Methicillin-Resistant Staphylococcus aureus - isolation & purification</subject><subject>Molecular biology</subject><subject>Molecular Diagnostic Techniques - methods</subject><subject>Mortality</subject><subject>Observational studies</subject><subject>Original Article</subject><subject>Pneumonia</subject><subject>Pneumonia, Ventilator-Associated - diagnosis</subject><subject>Pneumonia, Ventilator-Associated - drug therapy</subject><subject>Pneumonia, Ventilator-Associated - microbiology</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Real-Time Polymerase Chain Reaction - methods</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Staphylococcal Infections - diagnosis</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus infections</subject><subject>Thoracic surgery</subject><subject>Time Factors</subject><subject>Ventilators</subject><issn>0934-9723</issn><issn>1435-4373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkV1rFTEQhoMo9lj9Ad5IwBu92DbZfG0uS6lWOFCweh1ms9lzUvYkxyRbKPjjzbK1iCB4kxkyz7yZyYvQW0rOKCHqPNdTy4ZQ2bRKi0Y8QxvKmWg4U-w52hDNeKNVy07Qq5zvSO3plHqJTlqlKBeab9DPr3D0Ax487ELMxVtcXC4YwoDn7HAca1p87-NSgh34UKsHV_be-mnyoUku-1wqhG8LHPcPU7TR2jljmJOrwQcMwzyVmhQXsr932EJyeA6-vEYvRpiye_MYT9H3T1ffLq-b7c3nL5cX28ZypkvDe8Yp7SUllgkioe9Fz6EXI7FWa-nk0IEFxQetoG5OB2lHxQYgehyJAmCn6OOqu4fJHJM_QHowEby5vtia5Y5Q3ukqfU8r-2Fljyn-mOtfmIPP1k0TBBfnbGgnO8ZoS8V_oEwwTYla0Pd_oXdxTqEuvQiKVhAiVaXoStkUc05ufBqWErM4blbH67zSLI6bRfndo_LcH9zw1PHb4gq0K5BrKexc-uPpf6r-AhOptzE</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Dureau, A.-F.</creator><creator>Duclos, G.</creator><creator>Antonini, F.</creator><creator>Boumaza, D.</creator><creator>Cassir, N.</creator><creator>Alingrin, J.</creator><creator>Vigne, C.</creator><creator>Hammad, E.</creator><creator>Zieleskiewicz, L.</creator><creator>Leone, M.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><general>Springer Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-0788-4967</orcidid></search><sort><creationdate>20170201</creationdate><title>Rapid diagnostic test and use of antibiotic against methicillin-resistant Staphylococcus aureus in adult intensive care unit</title><author>Dureau, A.-F. ; Duclos, G. ; Antonini, F. ; Boumaza, D. ; Cassir, N. ; Alingrin, J. ; Vigne, C. ; Hammad, E. ; Zieleskiewicz, L. ; Leone, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-4b3411b610c3506abb5b4ab5f0cc996e6d8aca74d97a4371d6cf73da09ff07aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Diagnostic tests</topic><topic>Drug Utilization</topic><topic>Hospitals, University</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Intensive care</topic><topic>Intensive Care Units</topic><topic>Internal Medicine</topic><topic>Life Sciences</topic><topic>Medical Microbiology</topic><topic>Methicillin-Resistant Staphylococcus aureus - isolation & purification</topic><topic>Molecular biology</topic><topic>Molecular Diagnostic Techniques - methods</topic><topic>Mortality</topic><topic>Observational studies</topic><topic>Original Article</topic><topic>Pneumonia</topic><topic>Pneumonia, Ventilator-Associated - diagnosis</topic><topic>Pneumonia, Ventilator-Associated - drug therapy</topic><topic>Pneumonia, Ventilator-Associated - microbiology</topic><topic>Prospective Studies</topic><topic>Public health</topic><topic>Real-Time Polymerase Chain Reaction - methods</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Staphylococcal Infections - diagnosis</topic><topic>Staphylococcal Infections - drug therapy</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Staphylococcus aureus</topic><topic>Staphylococcus infections</topic><topic>Thoracic surgery</topic><topic>Time Factors</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dureau, A.-F.</creatorcontrib><creatorcontrib>Duclos, G.</creatorcontrib><creatorcontrib>Antonini, F.</creatorcontrib><creatorcontrib>Boumaza, D.</creatorcontrib><creatorcontrib>Cassir, N.</creatorcontrib><creatorcontrib>Alingrin, J.</creatorcontrib><creatorcontrib>Vigne, C.</creatorcontrib><creatorcontrib>Hammad, E.</creatorcontrib><creatorcontrib>Zieleskiewicz, L.</creatorcontrib><creatorcontrib>Leone, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>European journal of clinical microbiology & infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dureau, A.-F.</au><au>Duclos, G.</au><au>Antonini, F.</au><au>Boumaza, D.</au><au>Cassir, N.</au><au>Alingrin, J.</au><au>Vigne, C.</au><au>Hammad, E.</au><au>Zieleskiewicz, L.</au><au>Leone, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rapid diagnostic test and use of antibiotic against methicillin-resistant Staphylococcus aureus in adult intensive care unit</atitle><jtitle>European journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>36</volume><issue>2</issue><spage>267</spage><epage>272</epage><pages>267-272</pages><issn>0934-9723</issn><eissn>1435-4373</eissn><abstract>Ventilator-associated pneumonia (VAP) due to methicillin-resistant
Staphylococcus aureus
(MRSA) is associated with excess mortality and costs. Molecular biology test allows rapid identification of MRSA in sputum with high negative predictive value. We hypothesized that use of a rapid diagnostic test in patients with suspected VAP was associated with reduced use of antibiotics directed against MRSA. This retrospective, observational study was conducted in a polyvalent intensive care unit (ICU) of a university hospital. We compared two periods: before (2007–2010) and after (2010–2015) the implementation of a rapid diagnostic test, which uses RT-PCR to detect pathogens in 60 minutes. The primary endpoint was the effect on the empirical use of anti-MRSA antibiotics. The second endpoint was the effect of this strategy on the cost regarding antibiotic treatment. The first group included 120 suspected VAP (88 patients) and the second group 121 suspected VAP (89 patients). Empirical use of vancomycin and linezolid decreased by 50 % between the two periods. Twenty-seven VAP (22 %) were treated with an anti-MRSA treatment between 2007 and 2010, and 13 (11 %) between 2010 and 2015 (
p
= 0.04). The mean cost of anti-MRSA treatment by patients in the first group was 63 ± 223 €, and 13 ± 52 € in the second group (
p
< 0.001). This study shows that a rapid diagnostic test was associated with reduced use and cost of anti-MRSA antibiotics in patients with suspected VAP. These results should be confirmed by further multicenter prospective studies.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27714594</pmid><doi>10.1007/s10096-016-2795-5</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-0788-4967</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | European journal of clinical microbiology & infectious diseases, 2017-02, Vol.36 (2), p.267-272 |
| issn | 0934-9723 1435-4373 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_01489506v1 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Anti-Bacterial Agents - therapeutic use Antibiotics Biomedical and Life Sciences Biomedicine Diagnostic tests Drug Utilization Hospitals, University Human health and pathology Humans Infectious diseases Intensive care Intensive Care Units Internal Medicine Life Sciences Medical Microbiology Methicillin-Resistant Staphylococcus aureus - isolation & purification Molecular biology Molecular Diagnostic Techniques - methods Mortality Observational studies Original Article Pneumonia Pneumonia, Ventilator-Associated - diagnosis Pneumonia, Ventilator-Associated - drug therapy Pneumonia, Ventilator-Associated - microbiology Prospective Studies Public health Real-Time Polymerase Chain Reaction - methods Retrospective Studies Sepsis Staphylococcal Infections - diagnosis Staphylococcal Infections - drug therapy Staphylococcal Infections - microbiology Staphylococcus aureus Staphylococcus infections Thoracic surgery Time Factors Ventilators |
| title | Rapid diagnostic test and use of antibiotic against methicillin-resistant Staphylococcus aureus in adult intensive care unit |
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