Patients with gram-negative bacilli bloodstream infection multidrug resistant, gram negative bacilli, blood stream infections, rapid diagnostic test, time to treatment
Conditions
Interventions
1.Positive gram-negative bacilli blood cultures are subsequently tested using the O.K.N.V.I. RESIST-5 assay (rapid test) to detect the presence of OXA-48, KPC, NDM, VIM, and IMP carbapenemases
2.The r
inpatient wards via telephone and documented in the electronic medical record
3.A recommended antibiotic modification sheet is provided to each ward
however, the decision to adjust antimicrobial therapy depends on the attending physicians, reflecting a pragmatic, real-world approach,1.Positive gram-negative bacilli blood culture results will be re
inpatient wards via telephone and documented in the electronic medical record
No rapid carbapenemase test will be done
2. The decision to adjust antimicrobial therapy depends on the attending physicia
Experimental Device,No Intervention No treatment
Rapid lateral flow immunochromatographic assay (RESIST-5 O.K.N.V.I.),Standard of care
Sponsors
Natwadee Mungkarndee
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age 18 years or older 2. Positive gram negative bacilli from hemoculture at least 1 bottle 3. Admitted to one of the 12 inpatient wards at Bhumibol Adulyadej Hospital; including the Intensive Care Unit (ICU), Semi-ICU, internal medicine, surgical, and orthopedic ward, all of which have a documented history of patients with multidrug-resistant gram-negative bacilli bloodstream infections in previous years
Exclusion criteria
Exclusion criteria: 1.The patient was receiving palliative care at the time of randomization 2.The patient refused to participate in the study] 3.The patient underwent other previous researches that affect hemoculture
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to antibiotic modification within 72 hours Time (in hours) measured from the moment a gram stain result reports gram-negative bacilli from hemoculture to the time the patient receives an appropriate antimicrobial modification | — |
Secondary
| Measure | Time frame |
|---|---|
| Hazard rate of appropriate antibiotics adjustment within 72 hours Univariate, Multivariate regression analysis, using Log-rank test ,30-day all-cause mortality 30 days Count,Hospital Length of stay - Count,ICU length of stay - Count,Rate of C.difficile infection or MDRO infections 30 days Count,Baseline characteristics at enrollment, within 24 hour Univariate, Multivariate regression analysis | — |
Countries
Thailand
Contacts
Public ContactNatwadee Mungkarndee
Bhumibol Adulyadej Hospital
Outcome results
None listed