{Reference Type}: Journal Article
{Title}: Clinical and Microbiological Impact of Implementing a Decision Support Algorithm through Microbiologic Rapid Diagnosis in Critically Ill Patients: An Epidemiological Retrospective Pre-/Post-Intervention Study.
{Author}: Rodríguez A;Gómez F;Sarvisé C;Gutiérrez C;Giralt MG;Guerrero-Torres MD;Pardo-Granell S;Picó-Plana E;Benavent-Bofill C;Trefler S;Berrueta J;Canadell L;Claverias L;Esteve Pitarch E;Olona M;García Pardo G;Teixidó X;Bordonado L;Sans MT;Bodí M;
{Journal}: Biomedicines
{Volume}: 11
{Issue}: 12
{Year}: 2023 Dec 16
{Factor}: 4.757
{DOI}: 10.3390/biomedicines11123330
{Abstract}: <B>BACKGROUND: </B>Data on the benefits of rapid microbiological testing on antimicrobial consumption (AC) and antimicrobial resistance patterns (ARPs) are scarce. We evaluated the impact of a protocol based on rapid techniques on AC and ARP in intensive care (ICU) patients.<BR><B>METHODS: </B>A retrospective pre- (2018) and post-intervention (2019-2021) study was conducted in ICU patients. A rapid diagnostic algorithm was applied starting in 2019 in patients with a lower respiratory tract infection. The incidence of nosocomial infections, ARPs, and AC as DDDs (defined daily doses) were monitored.<BR><B>RESULTS: </B>A total of 3635 patients were included: 987 in the pre-intervention group and 2648 in the post-intervention group. The median age was 60 years, the sample was 64% male, and the average APACHE II and SOFA scores were 19 points and 3 points. The overall ICU mortality was 17.2% without any differences between the groups. An increase in the number of infections was observed in the post-intervention group (44.5% vs. 17.9%, p < 0.01), especially due to an increase in the incidence of ventilator-associated pneumonia (44.6% vs. 25%, p < 0.001). AC decreased from 128.7 DDD in 2018 to 66.0 DDD in 2021 (rate ratio = 0.51). An increase in Pseudomonas aeruginosa susceptibility of 23% for Piperacillin/tazobactam and 31% for Meropenem was observed.<BR><B>CONCLUSIONS: </B>The implementation of an algorithm based on rapid microbiological diagnostic techniques allowed for a significant reduction in AC and ARPs without affecting the prognosis of critically ill patients.