Impact of the Verigene Rapid Diagnostic Blood Test as an Antibiotic Stewardship Tool Amongst Hospitalized Patients in a Community Healthcare System

AbstractThe novel coronavirus disease 2019 (COVID-19) continues to be a major public health concern. The aim of this study was to describe the presenting characteristics, epidemiology and predictors of outcomes among confirmed COVID-19 cases seen at a large community healthcare system which serves the epicenter and diverse region of Florida. We conducted a retrospective analysis of individuals with lab-confirmed SARS-CoV-2 infection who were seen, from March 2, 2020 to May 31, 2020, at Memorial Healthcare System in South Florida. Data was extracted from a COVID-19 registry of patients with lab-confirmed SARS-CoV-2 infection. Univariate and backward stepwise multivariate logistic regression models were used to determine predictors of key study outcomes. There were a total of 1692 confirmed COVID-19 patients included in this study. Increasing age was found to be a significant predictor of hospitalization, 30-day readmission and death. Having a temperature of 38 °C or more and increasing comorbidity score were also associated with an increased risk of hospitalization. Significant predictors of ICU admission included having a saturated oxygen level less than 90%, hypertension, dementia, rheumatologic disease, having a respiratory rate greater than 24 breaths per minute. Being of Hispanic ethnicity and immunosuppressant utilization greatly increased the risk of 30-day readmission. Having an oxygen saturation less than 90% and an underlying neurological disorder were associated with an increased likelihood of death. Results show that a patient’s demographic, underlying condition and vitals at triage may increase or reduce their risk of hospitalization, ICU admission, 30-day readmission or death.

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Evaluation of Faecal Occult Blood Test and Lactoferrin Latex Agglutination Test in Screening Hospitalized Patients for Diagnosing Inflammatory and Non-Inflammatory Diarrhoea in Dhaka, Bangladesh

Digestion ◽

10.1159/000113042 ◽

2007 ◽

Vol 76 (3-4) ◽

pp. 256-261 ◽

Cited By ~ 10

Author(s):

Hasan Ashraf ◽

Johannes Beltinger ◽

Nur Haque Alam ◽

Pradip Kumar Bardhan ◽

Abu Syed Golam Faruque ◽

...

Keyword(s):

Blood Test ◽

Occult Blood ◽

Faecal Occult Blood Test ◽

Latex Agglutination ◽

Agglutination Test ◽

Hospitalized Patients ◽

Latex Agglutination Test ◽

Occult Blood Test ◽

Faecal Occult Blood ◽

Faecal Occult

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RCT Abstract - Fast multiplex bacterial PCR in the bronchoalveolar lavage for antibiotic stewardship in hospitalized patients with pneumonia at risk for Gram negative bacteria infection–the randomized FLAGSHIP II Study

10.1183/13993003.congress-2021.oa2852 ◽

2021 ◽

Author(s):

Andrei Darie ◽

Nina Khanna ◽

Kathleen Jahn ◽

Michael Osthoff ◽

Stefano Basetti ◽

...

Keyword(s):

At Risk ◽

Bronchoalveolar Lavage ◽

Antibiotic Stewardship ◽

Hospitalized Patients ◽

Gram Negative Bacteria ◽

Gram Negative

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A model for improving and assessing outpatient stewardship initiatives for acute respiratory infection

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.206 ◽

2019 ◽

Vol 40 (10) ◽

pp. 1198-1200 ◽

Cited By ~ 1

Author(s):

Joan Guzik ◽

Pooja Kothari ◽

Misha Sharp ◽

Belinda Ostrowsky ◽

Gopi Patel ◽

...

Keyword(s):

Healthcare System ◽

Respiratory Infection ◽

Antibiotic Stewardship ◽

Acute Respiratory Infection ◽

Respiratory Infections ◽

Acute Respiratory Infections ◽

New Yorker ◽

Stage 1

Many hospitals have established inpatient antibiotic stewardship programs (ASPs), but outpatient activities remain limited. In 2016, the United Hospital Fund (UHF), an independent nonprofit working to build a more effective healthcare system for every New Yorker, launched a 2-stage grant-funded initiative to evaluate outpatient antibiotic stewardship, focusing on adults with acute respiratory infections (ARIs). Conclusions from stage 1 included few outpatient antibiotic stewardship activities, variation in prescribing, macrolides as the most commonly prescribed antibiotic, and provider interest in improving prescribing.1

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Hypervirulent Klebsiella pneumoniae liver abscess: A case series of invasive disease and complications at an academic community healthcare system in Cambridge, Massachusetts

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1545 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S589-S589

Author(s):

Frances Ue ◽

Louann Bruno-Murtha ◽

Duncan Kuhn ◽

Linda Shipton

Keyword(s):

Klebsiella Pneumoniae ◽

Healthcare System ◽

Liver Abscess ◽

Case Series ◽

Invasive Disease ◽

Academic Community ◽

Community Healthcare

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Identifying risk factors for suicidal ideation across a large community healthcare system

Journal of Affective Disorders ◽

10.1016/j.jad.2020.07.047 ◽

2020 ◽

Vol 276 ◽

pp. 1038-1045

Author(s):

Emily Schriver ◽

Shari Lieblich ◽

Reem AlRabiah ◽

Danielle L. Mowery ◽

Lily A. Brown

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Healthcare System ◽

Community Healthcare ◽

Large Community

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1007. A novel approach to evaluate antibiotic utilization across the spectrum of inpatient and ambulatory care and implications for prioritization of antibiotic stewardship efforts

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.871 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S354-S354

Author(s):

Holly M Frost ◽

Bryan C Knepper ◽

Katherine C Shihadeh ◽

Timothy C Jenkins

Keyword(s):

Ambulatory Care ◽

Healthcare System ◽

Antibiotic Stewardship ◽

Antibacterial Agent ◽

Antibiotic Use ◽

Urgent Care ◽

Outpatient Clinics ◽

Integrated Healthcare ◽

Adult Outpatient ◽

Systemic Antibacterial

Abstract Background Antibiotic overuse remains a significant problem in inpatient and outpatient settings. The objective of this study was to develop a methodology to evaluate antibiotic use across inpatient and ambulatory care sites in an integrated healthcare system in order to prioritize antibiotic stewardship efforts. Methods We conducted an epidemiologic study of antibiotic use across an integrated healthcare system on 12 randomly-selected days between October 1, 2017 and September 30, 2018. Inpatients and perioperative patients were recorded as having received an antibiotic if they were administered ≥1 dose of a systemic antibacterial agent. Outpatients were recorded as having received an antibiotic if they were prescribed ≥1 systemic antibacterial agent. Results On the study days, 10.9% (95% CI 10.6–11.3%) of patients received an antibiotic. Of all antibiotics administered or prescribed, 54.1% were from ambulatory care (95% CI 52.6–55.7%), 38.0% were from the hospital, (95% CI 36.6–39.5%), and 7.8% (95% CI 7.1–7.8%) were perioperative. The emergency department/urgent care centers, adult outpatient clinics, and adult noncritical care inpatient wards accounted for 26.4% (95% CI: 25.0–27.7%), 23.8% (95% CI: 22.6–25.2), and 23.9% (95% CI 22.7–25.3) of antibiotic use, respectively. Only 9.2% (95% CI: 8.3–10.1%) of all antibiotics were administered in critical care units. Antibiotics with a broad spectrum of Gram-negative activity accounted for 30.4% (95% CI: 29.0–31.9%) of all antibiotics prescribed. Infections of the respiratory tract were the leading indication for antibiotic use. Conclusion In an integrated healthcare system, nearly three-quarters of antibiotic use occurred in the emergency department/urgent care centers, adult outpatient clinics, and adult noncritical care inpatient wards. Antibiotics with a broad spectrum of Gram-negative activity accounted for a large portion of antibiotic use. Analysis of antibiotic utilization across the spectrum of inpatient and ambulatory care is useful to prioritize antibiotic stewardship efforts. Disclosures All authors: No reported disclosures.

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