Balancing Speed and Cost: Economic Insights from Rapid Diagnostic Testing in Bloodstream Infections.

Area of Science:

• Clinical Microbiology
• Health Economics
• Infectious Diseases

Background:

• Rapid diagnostic tests (RDTs) for bloodstream infections (BSIs) aim to shorten pathogen identification time.
• Evidence on the real-world clinical and economic value of RDTs for BSIs is inconsistent.
• This study evaluated the impact of different rapid microbiological identification methods against standard culture.

Purpose of the Study:

• To compare clinical outcomes, antibiotic use, and hospital costs of rapid diagnostic methods versus conventional culture for BSIs.
• To assess the association between diagnostic modality and patient outcomes and healthcare expenditures.
• To determine factors influencing the value of rapid diagnostics in a hospital setting.

Main Methods:

• Retrospective observational study of 115 hospitalized patients with suspected or confirmed BSIs.
• Comparison of multiplex PCR (mPCR), FISH, and MALDI-TOF MS against conventional culture.
• Analysis of mortality, length of stay, antibiotic-days, and direct/indirect hospital costs, including adjusted analyses.

Main Results:

• No significant differences in mortality or length of stay were found across diagnostic groups.
• Multiplex PCR (mPCR) use was associated with increased antibiotic-days and antibiotic-related costs (p < 0.05).
• Rapid diagnostics showed heterogeneous clinical and economic effects, not independently associated with mortality or costs in adjusted analyses.

Conclusions:

• Rapid diagnostics expedite pathogen identification but yield varied clinical and economic outcomes.
• The overall value of rapid diagnostics is influenced by local implementation strategies and antimicrobial stewardship.
• Diagnostic speed alone does not solely determine the clinical and economic benefits of rapid methods for BSIs.