Does PCR-based pathogen identification reduce mortality in bloodstream infections? Insights from a...

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Health Services Research

Background:

• Bloodstream infections (BSI) pose significant mortality risks, especially with resistant pathogens.
• Timely diagnosis and treatment are critical for improving patient outcomes in BSI.
• Polymerase chain reaction (PCR) tests offer potential for rapid pathogen identification in BSI.

Purpose of the Study:

• To evaluate the impact of implementing BCID2 PCR testing on mortality risk in patients with enterococcal BSI.
• To assess the effectiveness of rapid diagnostic methods in infection control and antimicrobial treatment strategies.

Main Methods:

• A difference-in-differences analysis was conducted in a New York City hospital system.
• Compared mortality risk in enterococcal BSI patients before and after BCID2 PCR adoption.
• Used methicillin-sensitive S. aureus (MSSA) BSI patients as a control group.

Main Results:

• The study included 548 inpatients (164 VRE BSI, 384 MSSA BSI).
• The mean 30-day mortality risk difference post-intervention was -6.03 per 100 (95% CI: -10.35 to -1.7).
• Event study plots indicated minimal pre-treatment trend deviations.

Conclusions:

• BCID2 PCR testing for enterococcal BSI may be linked to reduced mortality.
• Estimates have relative imprecision, necessitating cautious interpretation.
• Further research with larger sample sizes is essential to confirm the impact of rapid PCR testing on BSI mortality.