Clinical and economic evaluation of the impact of rapid microbiological diagnostic testing

• Published in: The Journal of infection Vol. 65; no. 4; pp. 302 - 309
• Main Authors: Galar, A, Leiva, J, Espinosa, M, Guillén-Grima, F, Hernáez, S, Yuste, J.R
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-10-2012; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Antibiotic use; Bacterial Infections - diagnosis; Bacterial Infections - drug therapy; Bacteriological Techniques - economics; Bacteriological Techniques - methods; Biological and medical sciences; Diagnostics; Female; General aspects; Health Care Costs - statistics & numerical data; Hospital costs; Humans; Infectious Disease; Male; Medical sciences; Middle Aged; Time Factors; Treatment Outcome; Diagnostics; Antibiotic use; Hospital costs; Infection; Microbiological testing; Health economy; Economic aspect; Diagnosis; Economic impact; Epidemiology; Public health
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2012.06.006

Summary The clinical value of information provided by the Microbiology Laboratory may be reduced by the time it takes to generate results for healthcare providers. The aim of this study was to measure the clinical and economic impact associated with rapid reporting of microbiological results. Methods 574 hospitalized patients with a bacterial clinical infection confirmed by culture were evaluated. 284 hospitalized patients were included in the historical control group (results available the day following the analysis) and 290 in the intervention group (results available the same day of the analysis). The Vitek® 2 system (bioMérieux) was used for identification and antimicrobial susceptibility testing in both groups. Results Faster reporting of microbiological results enabled the clinician to optimize the antibiotic treatment sooner ( P  < 0.001). This reduction in turnaround time (17.6 h) was associated with improved clinical outcome, a significant reduction in the length of hospitalization and the number of microbiological and biochemical tests performed. Intubation requirements were significantly lower in the intervention group. Mortality rates did not differ significantly between the two groups. Costs incurred for patients in the intervention group were significantly lower than those in the control group, including costs for Microbiology Laboratory testing, antibiotic costs, length of hospitalization and other patient care costs. Conclusions Rapid microbiological information was associated with quality improvement seen in earlier changes in antibiotic use, an improved clinical outcome and financial benefits.