Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2020/06/stewardship-resistance-scan-jun-23-2020
Stewardship / Resistance Scan for Jun 23, 2020
Rapid blood culture testing; CARB-X funding for antibacterial peptides
Filed Under:
Antimicrobial Stewardship; Diagnostics
Rapid blood culture test tied to improved antibiotic therapy at children's hospital
The implementation of a rapid diagnostic testing platform at a children's hospital, coupled with real-time antibiotic stewardship program (ASP) result notification, was associated with improved antibiotic management of hospitalized children with gram-positive blood culture isolates, researchers reported today in Infection Control and Hospital Epidemiology.
For the study, researchers with the University of Michigan, the Perelman School of Medicine at the University of Pennsylvania, and Children's Hospital of Philadelphia (CHOP) looked at patients aged 0 to 21 admitted to CHOP with positive blood culture events 1 year before and 1 year after the implementation of the Verigene gram-positive blood culture test (BC-GP) with ASP support. BC-GP is a multiplex nucleic acid test that detects nine species and three genera of gram-positive bacteria, plus three genetic resistance determinants. Prior to the intervention, blood culture isolates were evaluated by conventional identification and susceptibility testing methods.
The primary outcome of the study was time to optimal antibiotic therapy for positive blood cultures before and after the intervention. Secondary outcomes included time to effective therapy, time to definitive therapy, time to stopping vancomycin, length of stay, and 30-day mortality. Time to therapy outcomes were compared using Cox regression models and interrupted time series analyses.
A total of 264 blood-culture events (191 gram-positive, 73 gram-negative) occurred before the intervention and 257 (168 gram-positive, 89 gram-negative) occurred after. The median age of patients was 2.9 years, and 418 patients had more than one complex chronic condition. For gram-positive isolates, implementation of BC-GP testing was associated with an immediate reduction in time to optimal therapy and time to stopping vancomycin in both analyses. BC-GP testing was also associated with decreased time to definitive therapy in the interrupted time series analysis, but not in the Cox regression models.
No changes in time to effective therapy, length of stay, or 30-day mortality were associated with BC-GP testing, and the intervention was not associated with any impact on outcomes for gram-negative infections.
"BC-GP could be an important tool for microbiology laboratories and ASPs in ongoing efforts to optimize antibiotic management for children with positive blood cultures," the authors concluded.
Jun 23 Infect Control Hosp Epidemiol abstract
CARB-X funds development of polymyxin-replacing antibiotic class
CARB-X announced yesterday that it will award up to $3.83 million to the University of Queensland's Institute for Molecular Bioscience to develop a new class of antibiotics to replace polymyxins as a last-resort option against multidrug-resistant infections.
Researchers at the institute are working to develop a class of antibiotics based on Octapeptin cyclic peptides that maintain their antibacterial potency against polymyxin-resistant gram-negative pathogens, but with fewer side effects than polymyxins, which can cause severe kidney and neurologic side effects. The peptides will be developed to treat a range of serious bacterial infections, including urinary tract and intra-abdominal infections and pneumonia.
"In our hospitals today, patients are being treated with last-resort antibiotics that can cause damaging side effects, and in some cases, do not even cure the infection," CARB-X chief of research and development Erin Duffy, PhD, said in a press release. "We are in a race against superbugs, and if the University of Queensland project is successful, it has the potential to treat drug-resistant infections safely and effectively, and to save lives."
The project will be eligible for an additional $7.03 million if it meets certain development milestones.
This is the first CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator) award to an academic institution, and the first to an entity in Australia.
Jun 22 CARB-X press release
Stewardship / Resistance Scan for Jun 23, 2020
Rapid blood culture testing; CARB-X funding for antibacterial peptides
Filed Under:
Antimicrobial Stewardship; Diagnostics
Rapid blood culture test tied to improved antibiotic therapy at children's hospital
The implementation of a rapid diagnostic testing platform at a children's hospital, coupled with real-time antibiotic stewardship program (ASP) result notification, was associated with improved antibiotic management of hospitalized children with gram-positive blood culture isolates, researchers reported today in Infection Control and Hospital Epidemiology.
For the study, researchers with the University of Michigan, the Perelman School of Medicine at the University of Pennsylvania, and Children's Hospital of Philadelphia (CHOP) looked at patients aged 0 to 21 admitted to CHOP with positive blood culture events 1 year before and 1 year after the implementation of the Verigene gram-positive blood culture test (BC-GP) with ASP support. BC-GP is a multiplex nucleic acid test that detects nine species and three genera of gram-positive bacteria, plus three genetic resistance determinants. Prior to the intervention, blood culture isolates were evaluated by conventional identification and susceptibility testing methods.
The primary outcome of the study was time to optimal antibiotic therapy for positive blood cultures before and after the intervention. Secondary outcomes included time to effective therapy, time to definitive therapy, time to stopping vancomycin, length of stay, and 30-day mortality. Time to therapy outcomes were compared using Cox regression models and interrupted time series analyses.
A total of 264 blood-culture events (191 gram-positive, 73 gram-negative) occurred before the intervention and 257 (168 gram-positive, 89 gram-negative) occurred after. The median age of patients was 2.9 years, and 418 patients had more than one complex chronic condition. For gram-positive isolates, implementation of BC-GP testing was associated with an immediate reduction in time to optimal therapy and time to stopping vancomycin in both analyses. BC-GP testing was also associated with decreased time to definitive therapy in the interrupted time series analysis, but not in the Cox regression models.
No changes in time to effective therapy, length of stay, or 30-day mortality were associated with BC-GP testing, and the intervention was not associated with any impact on outcomes for gram-negative infections.
"BC-GP could be an important tool for microbiology laboratories and ASPs in ongoing efforts to optimize antibiotic management for children with positive blood cultures," the authors concluded.
Jun 23 Infect Control Hosp Epidemiol abstract
CARB-X funds development of polymyxin-replacing antibiotic class
CARB-X announced yesterday that it will award up to $3.83 million to the University of Queensland's Institute for Molecular Bioscience to develop a new class of antibiotics to replace polymyxins as a last-resort option against multidrug-resistant infections.
Researchers at the institute are working to develop a class of antibiotics based on Octapeptin cyclic peptides that maintain their antibacterial potency against polymyxin-resistant gram-negative pathogens, but with fewer side effects than polymyxins, which can cause severe kidney and neurologic side effects. The peptides will be developed to treat a range of serious bacterial infections, including urinary tract and intra-abdominal infections and pneumonia.
"In our hospitals today, patients are being treated with last-resort antibiotics that can cause damaging side effects, and in some cases, do not even cure the infection," CARB-X chief of research and development Erin Duffy, PhD, said in a press release. "We are in a race against superbugs, and if the University of Queensland project is successful, it has the potential to treat drug-resistant infections safely and effectively, and to save lives."
The project will be eligible for an additional $7.03 million if it meets certain development milestones.
This is the first CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator) award to an academic institution, and the first to an entity in Australia.
Jun 22 CARB-X press release