Using Rapid Diagnostic Tests to Optimize Antimicrobial Selection in Antimicrobial Stewardship Programs

作者：Goff Debra A^*; Jankowski Christopher; Tenover Fred C

来源：Pharmacotherapy, 2012, 32(8): 677-687.

DOI：10.1002/j.1875-9114.2012.01137.x

• antimicrobial stewardship
• Staphylococcus aureus bacteremia
• Clostridium difficile
• candidemia
• rapid diagnostic tests
• microbiology
• polymerase chain reaction
• peptide nucleic acid fluorescent in situ hybridization

New advances in rapid diagnostic tests provide several collaborative opportunities for stewardship teams, particularly in processes where delay in the initiation of appropriate therapy has significant consequences for patient outcomes. Rapid molecular tests enhance one of the key functions of microbiology laboratories, which is to produce accurate organism identification and timely antimicrobial susceptibility testing data. These data are used to guide the choice of antimicrobial agents for treating infections in individual patients, and the aggregate data (i.e., hospital's antibiogram) are used to guide empiric therapy for infections before the availability of the patient's culture results and antimicrobial susceptibility testing data. In addition, accurate antimicrobial susceptibility testing data are critical for the overall success of a health care institution's antimicrobial stewardship program. Tests that provide accurate organism identification and antimicrobial susceptibility not only benefit the individual patient but also increase the effectiveness of antimicrobial stewardship programs. This review focuses on the use of molecular diagnostic methods to rapidly identify Staphylococcus species, Enterococcus faecalis,Enterococcus faecium, Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Clostridium difficile, and Candida species from clinical samples and summarizes studies that describe the application of rapid diagnostic tests in antimicrobial stewardship programs.

• 出版日期2012-8