{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:36:12Z","timestamp":1786703772552,"version":"build-2736575974"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100019559","name":"Carl von Ossietzky Universit\u00e4t Oldenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019559","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study assessed the impact of EUCAST\u2019s Rapid Antimicrobial Susceptibility Testing (RAST) on empirical therapy and its clinical usability in routine bloodstream infection management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective single-center, observational study compared two four-month periods before and after RAST implementation (Feb\u2013May 2023 vs. Feb\u2013May 2024) at Oldenburg Medical Center. Patients with monomicrobial bloodstream infections due to\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      ,\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      ,\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      , or\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      were included. Primary outcome: duration of empirical antimicrobial therapy. Secondary outcomes: turnaround time and categorical agreement between RAST with VITEK 2, including major errors (ME) and very major errors (VME). Surrogate-based interpretation was used for ATU results, particularly for piperacillin-tazobactam.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total 126 patients were included (66 in 2023, 60 in 2024). After RAST, empirical therapy duration was significantly shorter (40.5\u00a0h vs. 73.3\u00a0h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Median time to RAST result was 15.8\u00a0h, significantly shorter than by VITEK 2 (33.9\u00a0h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), reducing time to first susceptibility result by 9.6\u00a0h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001). Concordance with VITEK 2 was excellent: 100% for cefotaxime, meropenem, and piperacillin-tazobactam, 96.4% for ceftazidime, 95.2% for ampicillin. ATU results occurred mainly for piperacillin-tazobactam and were partly resolved through surrogate-based interpretation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RAST significantly shortened empirical therapy duration and accelerated susceptibility reporting with high agreement to VITEK 2. However, antibiotic-specific uncertainty and incomplete translation of early results into therapeutic action indicate that the clinical impact of RAST depends on structured interpretation and integration into antimicrobial stewardship workflows.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02829-4","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T09:21:32Z","timestamp":1779096092000},"page":"2001-2010","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical impact of EUCAST rapid antimicrobial susceptibility testing on empirical therapy in bloodstream infections: a real-world observational study"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9414-1045","authenticated-orcid":false,"given":"Lukas","family":"Schaffarczyk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia Carla","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1449-5780","authenticated-orcid":false,"given":"Axel","family":"Hamprecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5073-8829","authenticated-orcid":false,"given":"Philipp","family":"Thelen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"2829_CR1","unstructured":"Ten threats to global health in 2019. 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All other authors have no relevant financial or non-financial interests to disclose.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}