Use of a rapid detection test for extended-spectrum betalactamase from direct blood culture: an antimicrobial stewardship tool in a tertiary hospital in Spain.
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| Title: | Use of a rapid detection test for extended-spectrum betalactamase from direct blood culture: an antimicrobial stewardship tool in a tertiary hospital in Spain. |
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| Alternate Title: | Uso de un test de detección rápida de betalactamasas de espectro extendido a partir de hemocultivo directo: una herramienta para la optimización del uso de antimicrobianos en un hospital terciario de España. |
| Authors: | Rodríguez-Ayala, Montserrat1,2 ms.rodriguezayala@gmail.com, Cacho-Calvo, Juana1, Cendejas-Bueno, Emilio1,3 |
| Source: | Revista Española de Quimioterapia. abr2025, Vol. 38 Issue 2, p84-96. 13p. |
| Subjects: | ELECTRONIC health records, ANTIMICROBIAL stewardship, BACTEREMIA, DRUG resistance in bacteria, GRAM-negative bacteria |
| Abstract (English): | Introduction. Bacteremia caused by Gram-negative bacilli places a substantial burden on healthcare systems, mainly due to antibiotic resistance and delays in administering appropriate antimicrobial treatment (AT). The aim of this study was to describe the implementation of a rapid detection test (RDT) for CTX-M Extended Spectrum Beta-Lactamase-producing Enterobacterales (ESBL-PE) bacteremia as a tool for Antimicrobial Stewardship (AMS) in a tertiary hospital in Spain. Material and methods. A cross-sectional study was conducted on blood culture (BC) samples from adult patients (≥18 years) admitted to a tertiary hospital in Spain (January 2021-February 2024). BCs with confirmed Enterobacterales identification were included. An RDT was used to detect CTX-M ESBL from direct BC. The results were reported to the AMS team. Data from electronic medical records and our laboratory information system were analyzed to explore the utility of implementing an RDT as an AMS tool. Results. A total of 250 BCs from 250 patients were included. Empiric antimicrobial treatment (EAT) had not been prescribed in 41/250 (16.4%) patients, but was appropriately initiated in 33/250 (13.2%) after notification of the RDT results. Among those already receiving EAT (209/250, 83.6%), inappropriate and appropriate actions in AT were observed in 18/250 (7.2%) and 191/250 (76.4%) patients, respectively. By the time routine AST results were available, 241 (96.4%) patients had received appropriate treatment. Conclusions. This study demonstrated the real-world application of an RDT to detect CTX-M ESBL directly from BC in a tertiary hospital. Early reporting of CTX-M ESBL status in Enterobacterales bacteremia enabled physicians and AMS teams to optimize AT. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Introducción. Las bacteriemias por bacilos gramnegativos suponen una carga considerable para los sistemas sanitarios, debido principalmente a la resistencia antibiótica y a los retrasos en la administración de un tratamiento antimicrobiano (TA) adecuado. El objetivo de este estudio fue describir la implementación de un test de detección rápida (TDR) para identificar bacteriemias por Enterobacterales productoras de betalactamasas de espectro extendido (BLEE) de tipo CTX-M como herramienta para los programas de optimización del uso de antimicrobianos (PROA) en un hospital terciario de España. Materiales y métodos. Se realizó un estudio transversal de muestras de hemocultivo de pacientes adultos (≥18 años) ingresados en un hospital terciario de España (enero 2021-febrero 2024). Se incluyeron hemocultivos con una identificación confirmada de microorganismos del orden Enterobacterales. Se utilizó un TDR para detectar BLEE CTX-M a partir de hemocultivo directo. Los resultados se comunicaron al equipo PROA de nuestro hospital. Se analizaron los datos de historias clínicas electrónicas y de nuestro sistema de información de laboratorio para explorar la utilidad de la implementación del TDR. Resultados. Se incluyeron 250 hemocultivos. En 41/250 (16,4%) pacientes no se había prescrito tratamiento antimicrobiano empírico (TAE), pero en 33/250 (13,2%) se inició adecuadamente tras la notificación de los resultados del TDR. Entre los que ya recibían TAE (209/250, 83,6%), se observaron acciones inapropiadas y apropiadas en el tratamiento en 18/250 (7,2%) y 191/25 (76,4%) pacientes, respectivamente. Tras disponer de los resultados de susceptibilidad antibiótica de rutina, 241 pacientes (96,4%) recibieron tratamiento adecuado. Conclusiones. Este estudio demostró la aplicación de un TDR para detectar BLEE CTX-M en muestras de hemocultivo directo en un hospital terciario. La notificación temprana de los resultados de un TDR permitió a los médicos y a los equipos PROA optimizar el tratamiento antibiótico. [ABSTRACT FROM AUTHOR] |
| Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Items | – Name: Title Label: Title Group: Ti Data: Use of a rapid detection test for extended-spectrum betalactamase from direct blood culture: an antimicrobial stewardship tool in a tertiary hospital in Spain. – Name: TitleAlt Label: Alternate Title Group: TiAlt Data: Uso de un test de detección rápida de betalactamasas de espectro extendido a partir de hemocultivo directo: una herramienta para la optimización del uso de antimicrobianos en un hospital terciario de España. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Rodríguez-Ayala%2C+Montserrat%22">Rodríguez-Ayala, Montserrat</searchLink><relatesTo>1,2</relatesTo><i> ms.rodriguezayala@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Cacho-Calvo%2C+Juana%22">Cacho-Calvo, Juana</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Cendejas-Bueno%2C+Emilio%22">Cendejas-Bueno, Emilio</searchLink><relatesTo>1,3</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Revista+Española+de+Quimioterapia%22">Revista Española de Quimioterapia</searchLink>. abr2025, Vol. 38 Issue 2, p84-96. 13p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22ELECTRONIC+health+records%22">ELECTRONIC health records</searchLink><br /><searchLink fieldCode="DE" term="%22ANTIMICROBIAL+stewardship%22">ANTIMICROBIAL stewardship</searchLink><br /><searchLink fieldCode="DE" term="%22BACTEREMIA%22">BACTEREMIA</searchLink><br /><searchLink fieldCode="DE" term="%22DRUG+resistance+in+bacteria%22">DRUG resistance in bacteria</searchLink><br /><searchLink fieldCode="DE" term="%22GRAM-negative+bacteria%22">GRAM-negative bacteria</searchLink> – Name: Abstract Label: Abstract (English) Group: Ab Data: Introduction. Bacteremia caused by Gram-negative bacilli places a substantial burden on healthcare systems, mainly due to antibiotic resistance and delays in administering appropriate antimicrobial treatment (AT). The aim of this study was to describe the implementation of a rapid detection test (RDT) for CTX-M Extended Spectrum Beta-Lactamase-producing Enterobacterales (ESBL-PE) bacteremia as a tool for Antimicrobial Stewardship (AMS) in a tertiary hospital in Spain. Material and methods. A cross-sectional study was conducted on blood culture (BC) samples from adult patients (≥18 years) admitted to a tertiary hospital in Spain (January 2021-February 2024). BCs with confirmed Enterobacterales identification were included. An RDT was used to detect CTX-M ESBL from direct BC. The results were reported to the AMS team. Data from electronic medical records and our laboratory information system were analyzed to explore the utility of implementing an RDT as an AMS tool. Results. A total of 250 BCs from 250 patients were included. Empiric antimicrobial treatment (EAT) had not been prescribed in 41/250 (16.4%) patients, but was appropriately initiated in 33/250 (13.2%) after notification of the RDT results. Among those already receiving EAT (209/250, 83.6%), inappropriate and appropriate actions in AT were observed in 18/250 (7.2%) and 191/250 (76.4%) patients, respectively. By the time routine AST results were available, 241 (96.4%) patients had received appropriate treatment. Conclusions. This study demonstrated the real-world application of an RDT to detect CTX-M ESBL directly from BC in a tertiary hospital. Early reporting of CTX-M ESBL status in Enterobacterales bacteremia enabled physicians and AMS teams to optimize AT. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Spanish) Group: Ab Data: Introducción. Las bacteriemias por bacilos gramnegativos suponen una carga considerable para los sistemas sanitarios, debido principalmente a la resistencia antibiótica y a los retrasos en la administración de un tratamiento antimicrobiano (TA) adecuado. El objetivo de este estudio fue describir la implementación de un test de detección rápida (TDR) para identificar bacteriemias por Enterobacterales productoras de betalactamasas de espectro extendido (BLEE) de tipo CTX-M como herramienta para los programas de optimización del uso de antimicrobianos (PROA) en un hospital terciario de España. Materiales y métodos. Se realizó un estudio transversal de muestras de hemocultivo de pacientes adultos (≥18 años) ingresados en un hospital terciario de España (enero 2021-febrero 2024). Se incluyeron hemocultivos con una identificación confirmada de microorganismos del orden Enterobacterales. Se utilizó un TDR para detectar BLEE CTX-M a partir de hemocultivo directo. Los resultados se comunicaron al equipo PROA de nuestro hospital. Se analizaron los datos de historias clínicas electrónicas y de nuestro sistema de información de laboratorio para explorar la utilidad de la implementación del TDR. Resultados. Se incluyeron 250 hemocultivos. En 41/250 (16,4%) pacientes no se había prescrito tratamiento antimicrobiano empírico (TAE), pero en 33/250 (13,2%) se inició adecuadamente tras la notificación de los resultados del TDR. Entre los que ya recibían TAE (209/250, 83,6%), se observaron acciones inapropiadas y apropiadas en el tratamiento en 18/250 (7,2%) y 191/25 (76,4%) pacientes, respectivamente. Tras disponer de los resultados de susceptibilidad antibiótica de rutina, 241 pacientes (96,4%) recibieron tratamiento adecuado. Conclusiones. Este estudio demostró la aplicación de un TDR para detectar BLEE CTX-M en muestras de hemocultivo directo en un hospital terciario. La notificación temprana de los resultados de un TDR permitió a los médicos y a los equipos PROA optimizar el tratamiento antibiótico. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.37201/req/108.2024 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 84 Subjects: – SubjectFull: ELECTRONIC health records Type: general – SubjectFull: ANTIMICROBIAL stewardship Type: general – SubjectFull: BACTEREMIA Type: general – SubjectFull: DRUG resistance in bacteria Type: general – SubjectFull: GRAM-negative bacteria Type: general Titles: – TitleFull: Use of a rapid detection test for extended-spectrum betalactamase from direct blood culture: an antimicrobial stewardship tool in a tertiary hospital in Spain. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Rodríguez-Ayala, Montserrat – PersonEntity: Name: NameFull: Cacho-Calvo, Juana – PersonEntity: Name: NameFull: Cendejas-Bueno, Emilio IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: abr2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 02143429 Numbering: – Type: volume Value: 38 – Type: issue Value: 2 Titles: – TitleFull: Revista Española de Quimioterapia Type: main |
| ResultId | 1 |
