Date of Award

5-9-2015

Degree Type

Thesis

Degree Name

Honors Thesis

Department

Pharmacy

First Advisor

Kendra M. Damer

Abstract

Background: Traditional methods for detecting positive blood cultures include the use of broth bottles with sensitive indicators for growth. These techniques can take 24-48 hours to signal a positive test. Another 24 hours are often required to determine the species of the organism. The use of rapid diagnostic testing for Candida species bloodstream infections provides accurate species identification in less than two hours.

Objective: Evaluate the time to appropriate antifungal therapy in patients in which rapid diagnostic testing was utilized.

Methods: This study was a retrospective, observational cohort of patients who had positive blood cultures for Candida species and had PNA FISH® technology used as a rapid diagnostic test. Patients admitted to either Sidney & Lois Eskenazi or Wishard Memorial Hospital during the time frame of January 1,2012 to November 30,2014 were eligible for inclusion. Patients had to have at least one positive blood culture for Candida species. The following data was collected: demographics, microbiologic data, antimicrobial regimen, time to appropriate antimicrobial therapy, hospital length of stay and mortality.

Results: Of the 27 blood cultures in which PNA FISH® technology was used, the average time to appropriate antifungal therapy was 15.24 ± 17.7 hours. Therapy was appropriately initiated or adjusted after the PNA FISH® results in 33%) of patients (9/27). The mean hospital length of stay was 24.4 ± 18.8 days and the mean intensive care unit (lCU) length of stay was 15 ± 20.7 days. All-cause mortality was 22.2%) (6/27).

Conclusion: This study showed that the average time to appropriate antifungal therapy of 15.24 hours was comparable to current published studies. Due to the small number of patients in which therapy was appropriately adjusted after the PNA FISH®, it may be beneficial to educate healthcare providers about the usefulness of the PNA FISH® and how this technology may be utilized to enhance clinical practice and potentially improve patient outcomes.

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