The Impact of Implementation of Rapid QuickFISH Testing for Detection of Coagulase-Negative Staphylococci at a Community-Based Hospital.

Abstract

A study was conducted to evaluate the impact of implementing the Staphylococcus QuickFISH assay (AdvanDx, Woburn, MA), which rapidly detects and differentiates Staphylococcus aureus from coagulase-negative staphylococci (CoNS), together with an antimicrobial stewardship program on treating patients suspected of having sepsis. Two patient groups showing CoNS in positive blood cultures were evaluated by either conventional or QuickFISH testing with respect to turnaround time (TAT) for microorganism identification following Gram stain. Length of hospital stay (LOS) and days on the antibiotic vancomycin (DOV) were also compared. QuickFISH identification test accuracy was 100% compared with conventional testing. Average values for TAT, LOS, and DOV were all decreased as the result of QuickFISH testing; for acute-care patients hospitalized for 10 days or less, the main population of interest for this study, these three measures were all reduced significantly following implementation of QuickFISH vs conventional testing (P < .001, P = .0484, and P = .0084, respectively). Based on certain assumptions, QuickFISH testing also led to substantial cost savings. The QuickFISH assay, with its ability to provide timely and actionable results nearly simultaneously with the Gram stain, in conjunction with an effective antimicrobial stewardship program, has been adopted as standard of care at our community-based hospital.