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Article

Early Empirical Antibiotic Therapy Modification in Sepsis Using Beta-Lacta Test Directly on Blood Cultures

by
Assaf Mizrahi
1,2,
Françoise Jaureguy
3,
Héloise Petit
3,
Gauthier Péan de Ponfilly
1,2,
Etienne Carbonnelle
3,
Alban Le Monnier
1,2,
Jean-Ralph Zahar
3,4,* and
Benoît Pilmis
2,5
1
Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, 75014 Paris, France
2
Institut Micalis UMR 1319, INRAe, Université Paris-Saclay, AgroParisTech, 92290 Châtenay Malabry, France
3
Service de Microbiologie Clinique, Hôpitaux Universitaires de Paris Seine Denis, site Avicenne, AP-HP, 93000 Bobigny, France
4
UMR 1137, IAME, Université Paris, Sorbonne Paris Cité, 75018 Paris, France
5
Équipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, 75014 Paris, France
*
Author to whom correspondence should be addressed.
Int. J. Transl. Med. 2022, 2(3), 448-455; https://doi.org/10.3390/ijtm2030034
Submission received: 15 July 2022 / Revised: 5 August 2022 / Accepted: 8 August 2022 / Published: 26 August 2022
(This article belongs to the Special Issue Translational Aspects of Infectious Diseases: From Bench to Bedside 2.0)
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Abstract

Background: Sepsis caused by multi-drug-resistant Gram-negative bacilli lead physicians to prescribe broad-spectrum antibiotic therapy, such as carbapenems. Rapid susceptibility testing can help with the rational use of antibiotics. The aim of this study was to measure the clinical impact associated with rapid reporting of Beta-Lacta test (BLT) directly on blood cultures positive with Gram-negative bacilli. Methods: In an observational, multicentric, prospective study, we included patients with sepsis caused by Enterobacterales observed on Gram staining of the positive blood cultures. BLT and antimicrobial susceptibility testing (AST) were performed directly on the blood cultures. Clinical impact was measured on the proportion of patients for whom the probabilistic antibiotic therapy was modified according to BLT, including patients receiving carbapenem. Results: 170 patients were included, of whom 44 (25.9%) were receiving inadequate empirical antibiotic therapy. Among them, 27 (15.9%) benefited from an early modification, according to the BLT results. Among 126 (74.1%) patients receiving appropriate probabilistic antibiotic therapy, we modified the antibiotic therapy for 28 (16.5%) of them, including 4/14 (28.5%) de-escalation from carbapenem to a third-generation cephalosporin. Conclusions: Implementation of BLT performed directly on blood cultures allowed us to rapidly modify the empirical antibiotic therapy for about one-third of patients with sepsis caused by Enterobacterales.
Keywords: rapid diagnostic testing; ESBL; bloodstream infections rapid diagnostic testing; ESBL; bloodstream infections

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MDPI and ACS Style

Mizrahi, A.; Jaureguy, F.; Petit, H.; Péan de Ponfilly, G.; Carbonnelle, E.; Le Monnier, A.; Zahar, J.-R.; Pilmis, B. Early Empirical Antibiotic Therapy Modification in Sepsis Using Beta-Lacta Test Directly on Blood Cultures. Int. J. Transl. Med. 2022, 2, 448-455. https://doi.org/10.3390/ijtm2030034

AMA Style

Mizrahi A, Jaureguy F, Petit H, Péan de Ponfilly G, Carbonnelle E, Le Monnier A, Zahar J-R, Pilmis B. Early Empirical Antibiotic Therapy Modification in Sepsis Using Beta-Lacta Test Directly on Blood Cultures. International Journal of Translational Medicine. 2022; 2(3):448-455. https://doi.org/10.3390/ijtm2030034

Chicago/Turabian Style

Mizrahi, Assaf, Françoise Jaureguy, Héloise Petit, Gauthier Péan de Ponfilly, Etienne Carbonnelle, Alban Le Monnier, Jean-Ralph Zahar, and Benoît Pilmis. 2022. "Early Empirical Antibiotic Therapy Modification in Sepsis Using Beta-Lacta Test Directly on Blood Cultures" International Journal of Translational Medicine 2, no. 3: 448-455. https://doi.org/10.3390/ijtm2030034

APA Style

Mizrahi, A., Jaureguy, F., Petit, H., Péan de Ponfilly, G., Carbonnelle, E., Le Monnier, A., Zahar, J.-R., & Pilmis, B. (2022). Early Empirical Antibiotic Therapy Modification in Sepsis Using Beta-Lacta Test Directly on Blood Cultures. International Journal of Translational Medicine, 2(3), 448-455. https://doi.org/10.3390/ijtm2030034

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