Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital
Giancarlo Pérez‐Lazo, Juana del Valle-Mendoza, Roxana Sandoval‐Ahumada, Fernando Soto‐Febres, Raúl Castillo-Córdova, Melissa Zárate-Tantaleán, Liliana Morales-Castillo, Celia Joanna Páucar-Miranda, Milagros Altamirano-Molina, Iván Pacheco-Modesto, Claudia Ruiz de Somocurcio-Cruzado, Denis Arana-Jurado, Carmen del Villar-Alarcón, Olga Vargas-Castro, Carol Díaz-Bardales, Bruno Guerrero-Arismendiz, Renee Eyzaguirre-Zapata, Miguel Ángel Aguilar-Luis, Johanna Martins-Luna, Wilmer Silva-Caso
Abstract
The addition of Biofire® FilmArray® Blood Culture Identification panel 2 (BCID2) to the antimicrobial stewardship program (ASP) could improve outcomes in bloodstream infections (BSI) of patients with febrile neutropenia (FN). A pre- and post-quasi-experimental single-center study was conducted at a reference hospital in Peru. Three groups were considered: patients with BSI before ASP intervention (control group), patients with BSI after ASP intervention (group 1), and patients with BSI after ASP intervention plus BCID2 PCR Panel implementation (group 2). Overall, 93 patients were identified (32 control, 30 group 1, 31 group 2). The median time to effective therapy was significantly shorter in group 2 compared to group 1 and control group, respectively (3.75 vs. 10 h, p = 0.004; 3.75 vs. 19 h, p < 0.001). No significant differences in terms of relapse of bacteremia, in-hospital mortality (all cause), and 30-day-all-cause hospital readmission between the three study periods were found. The appropriateness of empirical antimicrobial use, adding or change, and the following de-escalation or discontinuation was significant when the two intervention periods were compared with the control group (p < 0.001). In addition to the lack of local studies documenting the microbiological profile of FN episodes, adding syndromic panels-based testing could allow for the consolidation of ASP strategies.