Impact of Rapid Molecular Diagnostic Testing on Outcomes of Patients With Vancomycin-Resistant Enterococcal Bacteremia

Abstract

Background Vancomycin-resistant enterococci (VRE) bacteremia is associated with substantial mortality. Rapid molecular diagnostic testing (RMDT) that detects enterococci and vancomycin resistance genes from positive blood culture broths may lead to earlier appropriate antimicrobial therapy for VRE bacteremia, which could improve clinical outcomes. Methods We conducted a retrospective cohort study of patients with VRE bacteremia from 2010 to 2019. RMDT that detects enterococci and vancomycin resistance genes from positive blood cultures was implemented in October 2014. We compared time to active antimicrobial administration, mortality, and other outcomes in patients whose positive blood cultures underwent RMDT (postintervention) and those whose did not (preintervention). Results Of 577 eligible patients with VRE bacteremia, 237 (41.1%) had blood cultures that underwent RMDT. The RMDT cohort had shorter median time from culture collection until receipt of active antimicrobial therapy (21 vs 32 hours, P