Elise M Gilbert1, Filiz Yucebay2, Mike Malczynski3, Danielle Smith4, John S Esterly1, Chao Qi5, Michael Postelnick6, Milena M McLaughlin7. 1. Northwestern Memorial Hospital, Department of Pharmacy, 251 E. Huron Street, Chicago, IL 60611, USA; Chicago State University College of Pharmacy, Department of Pharmacy Practice, 9501 S. King Drive, Chicago, IL 60628, USA. 2. Northwestern Memorial Hospital, Department of Pharmacy, 251 E. Huron Street, Chicago, IL 60611, USA; The James Cancer Hospital at The Ohio State Wexner Medical Center, 460 W10th Ave, Columbus, OH 43210, USA. 3. Northwestern Memorial Hospital, Clinical Microbiology Laboratory, 251 E. Huron Street, Chicago, IL 60611, USA. 4. Midwestern University Chicago College of Pharmacy, Department of Pharmacy Practice, 555 31st Street, Downers Grove, IL 60515, USA; Advocate Christ Medical Center and Children's Hospital, Department of Pharmacy, 4440 95th Street, Oak Lawn, IL 60453, USA. 5. Northwestern Memorial Hospital, Clinical Microbiology Laboratory, 251 E. Huron Street, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, Department of Pathology, 303 E Chicago Avenue, Chicago, IL 60611, USA. 6. Northwestern Memorial Hospital, Department of Pharmacy, 251 E. Huron Street, Chicago, IL 60611, USA. 7. Northwestern Memorial Hospital, Department of Pharmacy, 251 E. Huron Street, Chicago, IL 60611, USA; Midwestern University Chicago College of Pharmacy, Department of Pharmacy Practice, 555 31st Street, Downers Grove, IL 60515, USA. Electronic address: milgriff@nm.org.
Abstract
BACKGROUND: Organism detection by 16S ribosomal RNA (rRNA) PCR followed by amplicon sequencing identification may help guide antimicrobial treatment in culture-negative patients. The objectives of this study were to assess the effect of a positive versus negative 16S rRNA PCR on antibiotic length of therapy (LOT) and rate of antibiotic discontinuation. METHODS: Patients with a sterile site, direct-specimen 16S rRNA PCR negative, and suspected active infection were matched 1:1 with 16S rRNA PCR positive patients based on specimen site and retrospectively evaluated. RESULTS: Ninety patients were included (n=45 positive and negative). 16S rRNA PCR negative patients had shorter median LOT (33days [IQR 8-46] versus 43days [IQR 29-51], P=0.02). Antibiotics were discontinued more frequently in 16S rRNA PCR negative patients (38% versus 4%, P<0.01). CONCLUSIONS: For culture-negative patients with suspected sterile site infection, a negative, direct-specimen 16S rRNA PCR may help discontinue antibiotics and decrease LOT.
BACKGROUND: Organism detection by 16S ribosomal RNA (rRNA) PCR followed by amplicon sequencing identification may help guide antimicrobial treatment in culture-negative patients. The objectives of this study were to assess the effect of a positive versus negative 16S rRNA PCR on antibiotic length of therapy (LOT) and rate of antibiotic discontinuation. METHODS:Patients with a sterile site, direct-specimen 16S rRNA PCR negative, and suspected active infection were matched 1:1 with 16S rRNA PCR positive patients based on specimen site and retrospectively evaluated. RESULTS: Ninety patients were included (n=45 positive and negative). 16S rRNA PCR negative patients had shorter median LOT (33days [IQR 8-46] versus 43days [IQR 29-51], P=0.02). Antibiotics were discontinued more frequently in 16S rRNA PCR negative patients (38% versus 4%, P<0.01). CONCLUSIONS: For culture-negative patients with suspected sterile site infection, a negative, direct-specimen 16S rRNA PCR may help discontinue antibiotics and decrease LOT.
Authors: Tinzar Basein; Bradley J Gardiner; Gabriela M Andujar Vazquez; Andrew S Joel Chandranesan; Arthur R Rabson; Shira Doron; David R Snydman Journal: Open Forum Infect Dis Date: 2018-10-10 Impact factor: 3.835