TABLE 2

Microbiology, treatment, and clinical outcomes for all patientsa

ParameterValue(s)
Control (n = 115)Stewardship (n = 104)BCID (n = 145)P
Microbiology-related outcomes
    Time to blood culture positivity, h, median (IQR)17.3 (14.6–22.0)14.2 (12.9–18.2)b13.9 (11.9–18.5)b<0.001
    Time to organism identification, h, median (IQR)57.4 (42.5–68.5)53.9 (40.8–62.5)17.2 (13.3–24.8)b,c<0.001
    Time to in vitro susceptibility results, h, median (IQR)64.4 (57.4–70.6)61.5 (55.6–67.8)64.4 (58.6–78.1)c0.03
Blood culture pathogens
    Gram-positive bacteria (n = 168)51 (40.2)48 (44.4)59 (37.1)0.58
        Enterococcus faecalis (VRE)001
        Enterococcus faecalis (not VRE)8513
        Enterococcus faecium (VRE)001
        Enterococcus faecium (not VRE)100
        Enterococcus avium002
        Methicillin-resistant Staphylococcus aureus141413
        Methicillin-sensitive Staphylococcus aureus181518
        Staphylococcus spp. (coagulase negative)224
        Streptococcus agalactiae332
        Streptococcus pneumoniae212
        Streptococcus pyogenes011
        Streptococcus anginosus group205
        Streptococcus group C010
        Streptococcus group G010
        Streptococcus mitis454
    Gram-negative bacteria (n = 204)63 (49.6)54 (50)87 (54.7)0.58
        Acinetobacter baumannii224
        Enterobacter cloacae667
        Enterobacter aerogenes214
        Escherichia coli202734
        Klebsiella oxytoca101
        Klebsiella pneumoniae191321
        Proteus mirabilis324
        Pseudomonas aeruginosa536
        Serratia marcescens404
        Salmonella spp.102
    Candida spp. (n = 32)13 (10.2)6 (5.6)13 (8.2)0.58
        Candida albicans652
        Candida glabrata419
        Candida krusei100
        Candida parapsilosis101
        Candida tropicalis101
Treatment-related outcomes
    Time to effective therapy, h, median (IQR)15.0 (4.3–25.7)13.0 (4.3–23.1)4.9 (1.0–19.6)b,c<0.001
    Repeat positive blood cultures21/118 (17.8)11/103 (10.7)25/155 (16.1)0.31
    Microbiologic clearance within 3 days after blood culture draw100/127 (78.7)90/108 (83.3)128/159 (80.5)0.67
Clinical outcomes
    Length of hospitalization (LOS), no. of days, median (IQR) (n = 319)12 (7–20)9 (6–18)11 (7–24)0.33
    LOS, no. of days, following index blood culture collection, median (IQR) (n = 319)8.4 (5.5–15.6)7.8 (5.1–14.8)8.2 (5.2–15.9)0.88
    In-hospital mortality (all cause)13 (11.3)12 (11.5)20 (13.8)0.80
    Infection-related mortality7 (6.1)8 (7.7)13 (9.0)0.69
    30-day all-cause hospital readmission (n = 319)26 (25.5)24 (26.1)23 (18.4)0.31
    Relapse of bacteremia6 (5.2)4 (3.8)4 (2.7)0.59
    Total hospital costs (per patient), $, mean (median)57,442 (27,564)58,306 (21,222)47,992 (23,840)0.26
  • a Data are presented as number (percent) of patients, unless specified otherwise. Abbreviations: BCID, blood culture identification panel; IQR, interquartile range; VRE, vancomycin-resistant enterococci.

  • b Statistically significant compared to control group.

  • c Statistically significant comparison between the 2 intervention groups.