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J Med Microbiol 57 (2008), 1147-1151; DOI: 10.1099/jmm.0.2008/000430-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Influence of automated screening and confirmation of extended-spectrum β-lactamase-producing members of the Enterobacteriaceae on prescribing of antibiotics

Anthony M. Nicasio1, Joseph L. Kuti1, Jaber Aslanzadeh2 and David P. Nicolau1

1 Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT 06102, USA

2 Division of Clinical Microbiology, Hartford Hospital, Hartford, CT 06102, USA

Correspondence
David P. Nicolau
dnicola{at}harthosp.org

Received 16 January 2008
Accepted 29 April 2008

This study investigated the clinician response to the extended-spectrum β-lactamase (ESBL) confirmation report generated by an automated detection system, MicroScan Walkaway. The study compared two cohorts (pre- and post-automated detection) of patients with an ESBL-producing Escherichia coli or Klebsiella species non-urinary infection over the period October 2001–December 2006. Acceptance of the report, as defined by the initiation of carbapenem therapy, was observed in 69.2 % of the post-automated detection cohort (n=78) versus 20 % in the pre-automated detection period (n=15) (P ≤0.001). The utilization of a carbapenem increased progressively over the course of the study. Moreover, the time to initiation of carbapenem therapy was reduced from 15.7±4.9 to 0.1±2.0 days (P ≤0.001) after implementation of this automated detection system. Overall, clinicians responded positively to the ESBL automated detection report, as gauged by the increased utilization of a carbapenem and the earlier initiation of appropriate therapy; however, reductions in length of stay and mortality were not observed in this infected population.

Abbreviations: ESBL, extended-spectrum β-lactamase.






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