A new study at the University of Arizona Medical Centre, USA, has documented significant decreases in intensive care unit (ICU) mortality and hospital costs for patients with bloodstream infections after implementation of PNA FISH tests for rapid identification of bloodstream pathogens.
Results were presented at the recently concluded 51st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2011) in Chicago.
The retrospective study (pre-PNA FISH vs. post-PNA FISH intervention) assessed the clinical and financial impact of laboratory testing and reporting of PNA FISH results to guide therapeutic intervention by infectious diseases pharmacists and physicians using established treatment algorithms.
The study included patients with positive blood cultures admitted to the medical centre between August 2007 and March 2011.
A total of 460 patients with results indicative of enterococcal or streptococcal bacteremia, i.e., Gram-positive cocci in pairs and chains (GPCPC) from positive blood cultures, were included in the study.
Of these patients, 262 had PNA FISH performed. A total of 125 patients with yeast-positive blood cultures, indicative of candidemia, were also included, of which 82 had PNA FISH performed.
Turn-around time for confirmation of results for E. faecalis, E. faecium, and other streptococci was decreased by 3.3 days (4.4 to 1.1 days) and by 3.9 days (6.2 to 2.3 days) for Candida species
ICU mortality for enterococcal/streptococcal bacteremia was decreased by 47% (34.6% to 18.3%), p = 0.04.
ICU mortality for candidemia was decreased by 86% (41.7% to 5.9%), p = 0.02.
Cost avoidance greater than $4.7 million per year was documented
The authors, led by Donna M. Wolk, Associate Professor of Clinical Pathology at the University of Arizona and the BIO5 Institute for Collaborative Research, concluded that “through laboratory collaboration with infectious diseases pharmacists, testing and reporting of PNA FISH results to clinicians resulted in significant reductions in laboratory turn-around times and ICU mortality, and substantial reductions in overall mortality for our patients.”
Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2011)