Carmen Molina Pardines, Department of Microbiology, General University Hospital of Alicante-ISABIAL, Spain.
Rev Esp Quimioter. 2021 Jun;34(3):193-199. doi: 10.37201/req/109.2020. Epub 2021 Mar 23.
The aim of this study was to assess the impact of the information provided by the new Sepsis Chip Flow system (SFC) and other fast microbiological techniques on the selection of the appropriate antimicrobial treatment by the clinical researchers of an antimicrobial stewardship team.
Two experienced clinical researchers performed the theoretical exercise of independently selecting the treatment for patients diagnosed by bacteremia due to bacilli gram negative (BGN). At first, the clinicians had only available the clinical characteristics of 74 real patients. Sequentially, information regarding the Gram stain, MALDI-TOF, and SFC from Vitro were provided. Initially, the researchers prescribed an antimicrobial therapy based on the clinical data, later these data were complementing with information from microbiological techniques, and the clinicians made their decisions again.
The data provided by the Gram stain reduced the number of patients prescribed with combined treatments (for clinician 1, from 23 to 7, and for clinician 2, from 28 to 12), but the use of carbapenems remained constant. In line with this, the data obtained by the MALDI-TOF also decreased the combined treatment, and the use of carbapenems remained unchanged. By contrast, the data on antimicrobial resistance provided by the SFC reduced the carbapenems treatment.
From the theoretical model the Gram stain and the MALDI-TOF results achieved a reduction in the combined treatment. However, the new system tested (SFC), due to the resistance mechanism data provided, not only reduced the combined treatment, it also decreased the prescription of the carbapenems.
本研究旨在评估新型 Sepsis Chip Flow 系统(SFC)和其他快速微生物技术提供的信息对抗菌药物管理团队的临床研究人员选择适当抗菌治疗的影响。
两名经验丰富的临床研究人员独立对革兰氏阴性菌(BGN)菌血症患者进行理论治疗选择。首先,临床医生仅掌握 74 名真实患者的临床特征。随后提供了 Vitro 的革兰氏染色、基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)和 SFC 的信息。最初,研究人员根据临床数据开出处方,然后用微生物技术信息补充这些数据,临床医生再次做出决定。
革兰氏染色提供的数据减少了联合治疗的患者数量(对于临床医生 1,从 23 例减少到 7 例,对于临床医生 2,从 28 例减少到 12 例),但碳青霉烯类药物的使用保持不变。与此一致,MALDI-TOF 获得的数据也减少了联合治疗,碳青霉烯类药物的使用保持不变。相比之下,SFC 提供的抗菌药物耐药数据减少了碳青霉烯类药物的治疗。
从理论模型来看,革兰氏染色和 MALDI-TOF 的结果减少了联合治疗。然而,测试的新型系统(SFC)不仅通过提供的耐药机制数据减少了联合治疗,还减少了碳青霉烯类药物的处方。