TY - JOUR
T1 - Impact of reporting gram stain results from blood culture bottles on the selection of antimicrobial agents
AU - Uehara, Yuki
AU - Yagoshi, Michiko
AU - Tanimichi, Yumiko
AU - Yamada, Hiroko
AU - Shimoguchi, Kazuo
AU - Yamamoto, Sachiyo
AU - Yanai, Mitsuru
AU - Kumasaka, Kazunari
PY - 2009/7
Y1 - 2009/7
N2 - We assessed the usefulness of reporting direct blood Gram stain results compared with the results of positive blood cultures in 482 episodes and monitored impact on selection of antimicrobial treatment. We found that the reporting groups "Staphylococcus spp," "Pseudomonas spp and related organisms," and "yeasts" identified in this way matched perfectly with later culture identification. When the report indicated Staphylococcus spp or Pseudomonas spp and related organisms, physicians started or changed antimicrobials suitable for these bacteria more frequently than when "other streptococci" and "family Enterobacteriaceae" were reported (P < .05). Incorrect recognition of Acinetobacter spp as Enterobacteriaceae family is still the most challenging problem in this context. Gram stain results that definitively identify Staphylococcus spp, Pseudomonas spp and related organisms, and yeasts reliably can be rapidly provided by clinical laboratories; this information has a significant impact on early selection of effective antimicrobials. Further investigation is needed to assess the clinical impact of reporting Gram stain results in bacteremia.
AB - We assessed the usefulness of reporting direct blood Gram stain results compared with the results of positive blood cultures in 482 episodes and monitored impact on selection of antimicrobial treatment. We found that the reporting groups "Staphylococcus spp," "Pseudomonas spp and related organisms," and "yeasts" identified in this way matched perfectly with later culture identification. When the report indicated Staphylococcus spp or Pseudomonas spp and related organisms, physicians started or changed antimicrobials suitable for these bacteria more frequently than when "other streptococci" and "family Enterobacteriaceae" were reported (P < .05). Incorrect recognition of Acinetobacter spp as Enterobacteriaceae family is still the most challenging problem in this context. Gram stain results that definitively identify Staphylococcus spp, Pseudomonas spp and related organisms, and yeasts reliably can be rapidly provided by clinical laboratories; this information has a significant impact on early selection of effective antimicrobials. Further investigation is needed to assess the clinical impact of reporting Gram stain results in bacteremia.
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U2 - 10.1309/AJCP0H2DAMBXZUSS
DO - 10.1309/AJCP0H2DAMBXZUSS
M3 - Article
C2 - 19864229
AN - SCOPUS:67650447411
SN - 0002-9173
VL - 132
SP - 18
EP - 25
JO - American Journal of Clinical Pathology
JF - American Journal of Clinical Pathology
IS - 1
ER -