Bacteremia is a frequent infection in intensive care units. It is associated with a high mortality rate and the rapid implementation of appropriate antibiotic therapy is strongly correlated to patient clinical outcomes. Innovative technologies have emerged to shorten the turnaround time of blood culture samples by obtaining susceptibility testing of the incriminated pathogen at an early stage, and therefore to rapidly adjust the antibiotic therapy of patients with Gram-negative Bacilli bacteremia. The study investigators hypothesize that the implementation of the innovative BacT/Alert® VIRTUO®, BioFire® BCID2 and REVEAL® solutions for the analysis of blood culture samples will increase the proportion of patients with Gram-negative Bacilli bacteremia who receive appropriate and optimized antibiotic therapy 24 hours after blood culture collection.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
100
Samples from patients positive for Gram-negative bacteremia will be analyzed using the new BacT/Alert® VIRTUO®, BioFire® BCID2 and REVEAL® diagnostic solutions
Analysis of samples using diffusion on Mueller Hinton (MH) agar medium according to EUCAST.
CHU de Nîmes
Nîmes, France
Proportion of patients receiving optimized antibiotic therapy (adequate and narrowest spectrum antibiotic therapy) in patients with Gram-negative bacteremia 24 hours after blood culture samples
Yes/no: receiving optimized antibiotic therapy (effective and narrowest spectrum for the identified pathogen(s)) 24 hours after blood culture collection, before and after implementation of the new diagnostic solutions
Time frame: 24 hours
Time to adapt antibiotic therapy (optimized) based on susceptibility testing between the two periods of the study (before and after the implementation of innovative diagnostic technologies) following the collection of blood cultures
Hours (theoretical and real) between blood culture collection and the first change in antibiotic therapy based on the innovative diagnostic technologies solutions or the conventional susceptibility test
Time frame: 28 Days
Concordance of the REVEAL® rapid antibiotic susceptibility testing technology with reference methods
Categorical Agreement of antibiotics tested by REVEAL® technology compared to the reference method (agar plate susceptibility test)
Time frame: 28 Days
Patient survival
Vital status of patients
Time frame: 28 Days
Length of stay in intensive care unit
Number of days
Time frame: 28 Days
Prevalence rate of multiresistant bacteria between the "before" and "after" periods
Proportion of multiresistant bacteria in each evaluation period
Time frame: 28 Days
Prevalence rate of bacteria which are highly resistant to emerging antibiotics between the "before" and "after" periods
Proportion of bacteria which are highly resistant to emerging antibiotics in each evaluation period
Time frame: 28 Days
cost of the device for the healthcare facility
purchase price of the equipment, depreciation, consumables, additional human time if applicable
Time frame: 28 Days
Compare the amount per patient from the health insurance point of view.
amount associated with the number of days spent in intensive care
Time frame: 28 Days
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