{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:27:45Z","timestamp":1791412065928,"version":"4.3.3"},"reference-count":70,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,9]]},"abstract":"\n Context<\/jats:italic>\n .\u2014Early diagnosis of gram-negative bloodstream infections, prompt identification of the infecting organism, and appropriate antibiotic therapy improve patient care outcomes and decrease health care expenditures. In an era of increasing antimicrobial resistance, methods to acquire and rapidly translate critical results into timely therapies for gram-negative bloodstream infections are needed.\n <\/jats:p>\n \n Objective<\/jats:italic>\n .\u2014To determine whether mass spectrometry technology coupled with antimicrobial stewardship provides a substantially improved alternative to conventional laboratory methods.\n <\/jats:p>\n \n Design<\/jats:italic>\n .\u2014An evidence-based intervention that integrated matrix-assisted laser desorption and ionization time-of-flight mass spectrometry, rapid antimicrobial susceptibility testing, and near\u2013real-time antimicrobial stewardship practices was implemented. Outcomes in patients hospitalized prior to initiation of the study intervention were compared to those in patients treated after implementation. Differences in length of hospitalization and hospital costs were assessed in survivors.\n <\/jats:p>\n \n Results<\/jats:italic>\n .\u2014The mean hospital length of stay in the preintervention group survivors (n = 100) was 11.9 versus 9.3 days in the intervention group (n = 101;\n P<\/jats:italic>\n = .01). After multivariate analysis, factors independently associated with decreased length of hospitalization included the intervention (hazard ratio, 1.38; 95% confidence interval, 1.01\u20131.88) and active therapy at 48 hours (hazard ratio, 2.9; confidence interval, 1.15\u20137.33). Mean hospital costs per patient were $45\u2009709 in the preintervention group and $26\u2009162 in the intervention group (\n P<\/jats:italic>\n = .009).\n <\/jats:p>\n \n Conclusions<\/jats:italic>\n .\u2014Integration of rapid identification and susceptibility techniques with antimicrobial stewardship significantly improved time to optimal therapy, and it decreased hospital length of stay and total costs. This innovative strategy has ramifications for other areas of patient care.\n <\/jats:p>","DOI":"10.5858\/arpa.2012-0651-oa","type":"journal-article","created":{"date-parts":[[2012,12,6]],"date-time":"2012-12-06T18:11:44Z","timestamp":1354817504000},"page":"1247-1254","source":"Crossref","is-referenced-by-count":344,"title":["Integrating Rapid Pathogen Identification and Antimicrobial Stewardship Significantly Decreases Hospital Costs"],"prefix":"10.5858","volume":"137","author":[{"given":"Katherine K.","family":"Perez","sequence":"first","affiliation":[{"name":"From the Departments of Pharmacy (Drs Perez and Musick) and Pathology and Genomic Medicine (Drs Olsen, Davis, Land, and Musser, and Ms Cernoch), The Methodist Hospital, Houston, Texas; and the Center for Biostatistics (Dr Peterson), The Methodist Hospital Research Institute, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall J.","family":"Olsen","sequence":"additional","affiliation":[{"name":"From the Departments of Pharmacy (Drs Perez and Musick) and Pathology and Genomic Medicine (Drs Olsen, Davis, Land, and Musser, and Ms Cernoch), The Methodist Hospital, Houston, Texas; and the Center for Biostatistics (Dr Peterson), The Methodist Hospital Research Institute, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L.","family":"Musick","sequence":"additional","affiliation":[{"name":"From the Departments of Pharmacy (Drs Perez and Musick) and Pathology and Genomic Medicine (Drs Olsen, Davis, Land, and Musser, and Ms Cernoch), The Methodist Hospital, Houston, Texas; and the Center for Biostatistics (Dr Peterson), The Methodist Hospital Research Institute, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia L.","family":"Cernoch","sequence":"additional","affiliation":[{"name":"From the Departments of Pharmacy (Drs Perez and Musick) and Pathology and Genomic Medicine (Drs Olsen, Davis, Land, and Musser, and Ms Cernoch), The Methodist Hospital, Houston, Texas; and the Center for Biostatistics (Dr Peterson), The Methodist Hospital Research Institute, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Davis","sequence":"additional","affiliation":[{"name":"From the Departments of Pharmacy (Drs Perez and Musick) and Pathology and Genomic Medicine (Drs Olsen, Davis, Land, and Musser, and Ms Cernoch), The Methodist Hospital, Houston, Texas; and the Center for Biostatistics (Dr Peterson), The Methodist Hospital Research Institute, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey A.","family":"Land","sequence":"additional","affiliation":[{"name":"From the Departments of Pharmacy (Drs Perez and Musick) and Pathology and Genomic Medicine (Drs Olsen, Davis, Land, and Musser, and Ms Cernoch), The Methodist Hospital, Houston, Texas; and the Center for Biostatistics (Dr Peterson), The Methodist Hospital Research Institute, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif E.","family":"Peterson","sequence":"additional","affiliation":[{"name":"From the Departments of Pharmacy (Drs Perez and Musick) and Pathology and Genomic Medicine (Drs Olsen, Davis, Land, and Musser, and Ms Cernoch), The Methodist Hospital, Houston, Texas; and the Center for Biostatistics (Dr Peterson), The Methodist Hospital Research Institute, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Musser","sequence":"additional","affiliation":[{"name":"From the Departments of Pharmacy (Drs Perez and Musick) and Pathology and Genomic Medicine (Drs Olsen, Davis, Land, and Musser, and Ms Cernoch), The Methodist Hospital, Houston, Texas; and the Center for Biostatistics (Dr Peterson), The Methodist Hospital Research Institute, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"1","key":"i1543-2165-137-9-1247-b01","series-title":"Chest","first-page":"146","article-title":"The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting","volume":"118","author":"Ibrahim\n EH,","year":"2000","unstructured":"Ibrahim\n EH, \n \n Sherman\n G, \n \n Ward\n S, \n \n Fraser\n VJ, \n \n Kollef\n MH. \n \n The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. 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J Clin Microbiol. 2010;48(4):1481\u20131483."},{"issue":"6","key":"i1543-2165-137-9-1247-b11","series-title":"J Mol Diagn","first-page":"701","article-title":"Novel, improved sample preparation for rapid, direct identification from positive blood cultures using matrix-assisted laser desorption\/ionization time-of-flight (MALDI-TOF) mass spectrometry","volume":"13","author":"Schubert\n S,","year":"2011","unstructured":"Schubert\n S, \n \n Weinert\n K, \n \n Wagner\n C, \n et al\n . Novel, improved sample preparation for rapid, direct identification from positive blood cultures using matrix-assisted laser desorption\/ionization time-of-flight (MALDI-TOF) mass spectrometry. 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