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Journal of Clinical Microbiology, May 1999, p. 1415-1418, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Clinical and Financial Benefits of Rapid Bacterial
Identification and Antimicrobial Susceptibility Testing
Joan
Barenfanger,1,*
Cheryl
Drake,1 and
Gail
Kacich2
Laboratory Medicine1
and Clinical Data Management,2 Memorial
Medical Center, Springfield, Illinois 62781
Received 30 November 1998/Returned for modification 12 January
1999/Accepted 6 February 1999
To assess the expected clinical and financial benefits of rapid
reporting of microbiology results, we compared patients whose cultured
samples were processed in the normal manner to patients whose samples
were processed more rapidly due to a minor change in work flow. For the
samples tested in the rapid-reporting time period, the vast majority of
bacterial identification and antimicrobial susceptibility testing (AST)
results were verified with the Vitek system on the same day that they
were available. This time period was called rapid AST (RAST). For RAST,
a technologist on the evening shift verified the data that became
available during that shift. For the control time period, cultures were
processed in the normal manner (normal AST [NAST]), which did not
include evening-shift verification. For NAST, the results for
approximately half of the cultures were verified on the first day that
the result was available. The average turnaround time for the reporting
of AST results was 39.2 h for RAST and 44.4 h for NAST (5.2 h
faster for RAST [P = 0.001]). Subsequently,
physicians were able to initiate appropriate antimicrobial therapy
sooner for patients whose samples were tested as part of RAST
(P = 0.006). The mortality rates were 7.9 and 9.6%
for patients whose samples were tested as part of RAST and NAST,
respectively (P = 0.45). The average length of stay was 10.7 days per patient for RAST and 12.6 days for NAST, a
difference of 2.0 days less for RAST (P = 0.006). The
average variable cost was $4,927 per patient for RAST and $6,677 for
NAST, a difference of $1,750 less per patient for RAST
(P = 0.001). This results in over $4 million in
savings in variable costs per year in our hospital.
*
Corresponding author. Mailing address: Laboratory
Medicine, Memorial Medical Center, 701 N. First St., Springfield, IL
62781. Phone: (217) 788-3000. Fax: (217) 788-5577. E-mail:
barenfanger.joan{at}mhsil.com.
Journal of Clinical Microbiology, May 1999, p. 1415-1418, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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