Table of Contents
SRX Pharmacology
Volume 2010 (2010), Article ID 395215, 6 pages
http://dx.doi.org/10.3814/2010/395215
Research Article

The Utility of Rapid Microbiological and Molecular Techniques in Optimizing Antimicrobial Therapy

1Department of Pharmacy, Huntsville Hospital, 101 Sivley Road, Huntsville, AL 35801, USA
2Department of Pharmacy, LSU Health Sciences Center, 1541 Kings Hwy, Shreveport, LA 71130, USA
3Diatherix Laboratories, 601 Genome Way—Suite 4208, Huntsville, AL 35806, USA
4Department of Microbiology, Huntsville Hospital, 911 Big Cove Road, Huntsville, AL 35801, USA
5UAB Huntsville Campus, 301 Governors Drive—Suite 310, Huntsville, AL 35801, USA
6Alabama Infectious Disease Center, 420 Lowell Drive Southeast, Huntsville, AL 35801, USA
7Quality Management Services, Huntsville Hospital, 101 Sivley Road, Huntsville, AL 35801, USA

Received 12 October 2009; Revised 13 January 2010; Accepted 14 January 2010

Copyright © 2010 Edward H. Eiland III et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Early treatment of bloodstream infections with appropriate, definitive antimicrobial therapy has proven to reduce mortality, length of hospital stay, and healthcare costs. Culture-based testing methods require up to five days for final pathogen identification and susceptibility reporting, forcing use of broad spectrum empiric therapy. Recently, multiple rapid microbiological and molecular testing methods have been developed that reduce the time to identify the pathogen and susceptibility, allowing optimal antimicrobial therapy to be prescribed earlier. Real-time polymerase chain reaction and gene microarray have been described in literature, yet only peptide nucleic acid fluorescent in-situ hybridization has published data justifying its use based on clinical outcomes and cost savings. Target enriched multiplex polymerase chain reaction was developed to identify both the pathogen and multiple genes associated with resistance from blood within 6 hours and this methodology was studied in our hospital to assess effectiveness at optimizing antimicrobials in staphylococcal bloodstream infections.