TABLE 3.
Clinical outcomes in phases 1 and 2 of postintervention perioda
| Outcomeb | Phase 1 (n = 182) | Phase 2 (n = 151) | P value |
|---|---|---|---|
| Microbiology results (median [IQR]) (days) | |||
| Gram stain | 0.7 (0.7–0.7) | 0.7 (0.6–0.7) | 0.28 |
| Organism identification | 1.7 (1.7–1.9) | 0.8 (0.7–0.8) | <0.001 |
| Final antimicrobial susceptibility report | 3.3 (2.9–3.8) | 3.0 (2.7–3.9) | 0.93 |
| Empirical antimicrobial therapy within 48 h (n [%]) | |||
| Combination therapy | 26 (14) | 23 (15) | 0.81 |
| Antipseudomonal agents | 133 (73) | 119 (79) | 0.22 |
| Carbapenems | 22 (12) | 10 (7) | 0.10 |
| Appropriate empirical therapy within 48 h (n [%]) | |||
| Overall | 173 (95) | 144 (95) | 0.90 |
| Pitt bacteremia score of ≥4 | 27/28 (96) | 36/37 (97) | 0.99 |
| BSI due to P. aeruginosa/CAE | 34/36 (94) | 32/32 (100) | 0.49 |
| Time to de-escalation (median [IQR]) (days)c | |||
| Combination therapy | 2.0 (1.0–2.8) | 1.0 (1.0–2.0) | 0.03 |
| Antipseudomonal beta-lactams | 2.7 (2.5–3.0) | 2.2 (2.0–2.5) | 0.04 |
| Carbapenems | 2.8 (2.0–3.3) | 2.1 (1.0–2.9) | 0.32 |
a
Phase 1, MALDI-TOF MS; phase 2, MALDI-TOF MS plus FilmArray BCID.
b
IQR, interquartile range; CAE, AmpC-producing Enterobacteriaceae.
c
Numbers of subjects eligible for de-escalation in phases 1 and 2 of the postintervention period were 26 and 23 for combination therapy, 87 and 69 for antipseudomonal beta-lactams, and 35 and 17 for carbapenems, respectively.