Clinical and Economic Impact of Rapid Blood Pathogen Identification Via Verigene

Introduction: Bloodstream infections (BSIs) are associated with increased morbidity and mortality if not treated appropriately. Rapid identification of microorganisms will allow clinicians the opportunity to modify initial broad-spectrum antibiotic therapy and improve patient outcomes in bacteremia. We aim to evaluate the impact of the Verigene Gram-positive blood culture (BC-GP) technology on time to modification of antibiotic therapy by clinicians. Methods: This was a retrospective research study conducted at Corpus Christi Medical Center. Verigene BC-GP technology was employed to rapidly identify microorganisms in patients with suspected Gram-positive bacteremia. Empiric antibiotic therapy was modified via de-escalation or escalation when culture results became available. The primary outcome for this study was the mean time to modification of antibiotic therapy after Verigene BC-GP results became available. Data analysis was conducted from data collected between January 2015 and August 2017 to assess the clinical and pharmacoeconomic impact of BC-GP. Results: Data were collected on 159 patients, with 123 of 159 (77%) meeting the inclusion criteria. The mean age was 66 ± 14.9 years, with 53/123 (43%) females and 70/123 (57%) males. Positive cultures identified were as follows: Streptococcus species (34), Staphylococcus species (72), 31/72 (43%) were MRSA, and Enterococcus species (19), 4/19 (21%) were Vancomycin-resistant Enterococcus (VRE). Antibiotic therapies in 31 of 123 patients (25%) were escalated, and 29 of 123 (24%) were de-escalated. Therapy was determined to be appropriate based on culture results in 63 of 123 (51%) patients, and thus therapy was not modified in this group. The mean time to escalate therapy was 6.2 ± 6 h and 9.2 ± 12.1 h to de-escalate. The average time for modification of antibiotic therapy was 7.6 ± 9.5 h. The conventional approach would take approximately 24-72 h for pathogen identification. Data on cost savings per intervention is estimated to be approximately $4000 per intervention. Based on this model, we estimate approximately $240,000 in cost savings from the 60 cases where interventions occurred. Conclusion: There is a significant time advantage to pathogen identification, therapy modification as well as a pharmacoeconomic benefit associated with the Verigene GC-GP system as compared to the conventional approach, which translates to positive patient outcomes.