[Rapid microbiological diagnosis of bacteremia in pediatrics: a quasi-experimental study]

Timely treatment of bacteremia is essential to reduce morbidity and mortality. Multidisciplinary collaboration and the use of rapid microbiological diagnostic methods are key to optimizing antibiotic (ATB) use.

To compare reporting time, clinical outcomes, and antibiotic use in children with bacteremia before and after the integration of FilmArray® (FA) into an antibiotic stewardship program. Materials y methods: A quasi-experimental beforeand- after study was conducted to evaluate the integration of FA into an antibiotic stewardship program. Patients younger than 18 years with bacteremia hospitalized at a pediatric hospital were randomly included. Clinical, microbiological, and antibiotic-related variables were analyzed. Statistical analysis was performed using STATA 16.

A total of 173 patients were included: 88 in the pre-intervention period and 85 in the post-intervention period; 58 (57%) were male. The median age was 57 months (IQR: 16-112), and 142 patients (83%) had comorbidities. The groups were comparable. In the post-intervention period, there was a significant increase in the proportion of patients who underwent antibiotic adjustment (41% vs. 55%; p=0.01) and in adjustments made within the first 48 hours after blood culture collection (31% vs. 47%; p=0.02). A reduction in the number of days of empirical meropenem and vancomycin use was observed. Time to microbiological reporting decreased from 26 hours (IQR: 20-32) to 6 hours (IQR: 2-6) with FA (p=0.001).

The integration of FA within a multidisciplinary approach was associated with a reduction in time to microbiological reporting and optimization of antibiotic use.