Department of Pharmacy, The Ohio State University Medical Center, Columbus, Ohio 43210, USA.
Clin Infect Dis. 2010 Nov 1;51(9):1074-80. doi: 10.1086/656623.
Rapid organism detection of Staphylococcus aureus bacteremia and communication to clinicians expedites antibiotic optimization. We evaluated clinical and economic outcomes of a rapid polymerase chain reaction methicillin‐resistant S. aureus/S. aureus blood culture test (rPCR). This single‐center study compared inpatients with S. aureus bacteremia admitted from 1 September 2008 through 31 December 2008 (pre‐rPCR) and those admitted from 10 March 2009 through 30 June 2009 (post‐rPCR). An infectious diseases pharmacist was contacted with results of the rPCR; effective antibiotics and an infectious diseases consult were recommended. Multivariable regression assessed clinical and economic outcomes of the 156 patients. Mean time to switch from empiric vancomycin to cefazolin or nafcillin in patients with methicillin‐susceptible S. aureus bacteremia was 1.7 days shorter post‐rPCR (P = .002). In the post‐rPCR methicillin‐susceptible and methicillin‐resistant S. aureus groups, the mean length of stay was 6.2 days shorter (P = .07) and the mean hospital costs were $21,387 less (P = .02). rPCR allows rapid differentiation of S. aureus bacteremia, enabling timely, effective therapy and is associated with decreased length of stay and health care costs.
快速检测金黄色葡萄球菌菌血症病原体并及时与临床医生沟通，有助于优化抗生素治疗方案。我们评估了一种快速聚合酶链反应耐甲氧西林金黄色葡萄球菌/金黄色葡萄球菌血培养检测（rPCR）的临床和经济效果。这项单中心研究比较了 2008 年 9 月 1 日至 12 月 31 日（rPCR 前）和 2009 年 3 月 10 日至 6 月 30 日（rPCR 后）期间因金黄色葡萄球菌菌血症入院的住院患者。传染病药剂师会根据 rPCR 的结果进行联系，并推荐有效的抗生素和传染病咨询。多变量回归分析了 156 例患者的临床和经济结局。rPCR 后，耐甲氧西林金黄色葡萄球菌菌血症患者从经验性万古霉素转为头孢唑林或萘夫西林的平均时间缩短了 1.7 天（P =.002）。在 rPCR 后耐甲氧西林和耐甲氧西林金黄色葡萄球菌组中，平均住院时间缩短了 6.2 天（P =.07），平均住院费用减少了 21387 美元（P =.02）。rPCR 可以快速区分金黄色葡萄球菌菌血症，实现及时有效的治疗，并与缩短住院时间和降低医疗成本相关。
