To determine if the use of rapid molecular diagnostic testing (RMDT) that detects VRE directly from positive blood culture broths is associated with improved clinical outcomes, specifically time to treatment and mortality rates, in patients with VRE bacteremia.
Key Findings:
RMDT cohort had a shorter median time to active antimicrobial therapy (21 vs 32 hours, P < .001), indicating a significant improvement in treatment initiation.
No significant difference in 30-day mortality between RMDT and non-RMDT cohorts (31.6% vs 36.5%, P = .230), suggesting mortality outcomes were similar.
Subgroup analysis excluding leukemia patients showed RMDT was associated with decreased 30-day mortality (29.6% vs 40.8%, P = .037), highlighting potential benefits in specific populations.
Improvement in 30-day mortality in patients without leukemia did not persist on multivariate analysis, indicating the need for further investigation.
Interpretation:
RMDT may reduce the time to identification and treatment of VRE bacteremia, but does not clearly improve clinical outcomes, particularly mortality, suggesting a need for further studies to explore these findings.
Limitations:
Retrospective design may introduce bias, limiting the ability to establish causation.
Subgroup analysis may lack power due to smaller sample size, potentially affecting the reliability of the findings.
Conclusion:
RMDT for VRE bacteremia improves time to treatment but does not demonstrate a clear benefit in mortality outcomes, emphasizing the need for ongoing research in this area.
by Michael R Hovan, Michael J Burkitt, Sierra A Derti, Judith U Hargrave, Angela S De Cordova, Matthew S Simon, Stephen G Jenkins, Lars F Westblade, Michael J Satlin
The newest member of the cellular therapy research team and Chief of the Bone Marrow and Transplantation Service at Roswell Park Comprehensive Cancer Center is eager to continue advancing the field.
