Clinical impact of implementation of rapid diagnostic testing of blood cultures with Staphylococcus aureus on patient outcomes.

Rapid diagnostic testing in microbiology labs shortens the time to identification of bacteria in blood cultures. Cepheid® GeneXpert® MRSA/SA PCR can be used to distinguish MRSA and MSSA from non-Staphylococcus aureus organisms in blood cultures. This study aims to determine if implementation of MRSA/SA PCR for blood culture pathogen identification, plus daily antimicrobial stewardship intervention, can reduce time to appropriate therapy, vancomycin duration, 30 day mortality, and 90 day recurrence in veterans. A total of 113 patients in the pre-implementation cohort and 73 patients in the post-implementation cohort were evaluated. Time to appropriate therapy was decreased from 49.8 (pre-implementation) to 20.6 (post-implementation) hours. There was a numerically shorter median duration of vancomycin therapy in the post-implementation group. There was no difference in 30 day mortality or 90 day recurrence between groups. Use of MRSA/SA PCR can improve antimicrobial use when combined with once-daily antimicrobial stewardship review.

[Investigation on malaria rapid diagnostic testing (RDT) - related knowledge, attitude and practice in primary healthcare professionals of Jiangsu Province].

OBJECTIVE: To investigate the malaria rapid diagnostic testing (RDT) - related knowledge, attitude, practice (KAP) of primary healthcare professionals in Jiangsu Province and analyze the corresponding influencing factors. METHODS: Four cities in Jiangsu Province were selected as the study sites by the typical sampling method to conduct a survey for the RDT related KAP and work satisfaction of primary healthcare professionals, and the multiple logistic regression model was used to explore the relevant influencing factors. RESULTS: Totally 1 150 questionnaires were issued and 949 valid questionnaires were collected with the recovery rate of 82.52%. The valid questionnaires included 453 questionnaires from laboratory technicians, 466 from clinicians, and 30 from malaria prevention and control workers. Totally 83.98% of the surveyed professionals had a low mastering level of essential RDT-related knowledge. A total of 52.17% of the surveyed laboratory technicians recognized that the application of RDT technology could effectively improve the current primary-level microscopy work, and the degree of recognition of RDT technological advantage in the laboratory technicians was higher than that in the clinicians. Totally 79.25% of the surveyed laboratory technicians regarded themselves to be capable of conducting the standardized RDT operation, and 84.55% of the surveyed clinicians regarded themselves to be capable of conducting the qualified malaria clinical diagnostic practice. The key influencing factors of RDT-related KAP of primary healthcare professionals included the laboratory technicians' gender, educational level, employer's institutional level, professional title, and working years, and the employer's institutional level of clinicians. CONCLUSIONS: The primary healthcare professionals in Jiangsu Province exhibita good acceptability towards RDT technology. However, their essential knowledge on RDT remains to be improved. Therefore, it is necessary to establish a specific training and educational system for primary healthcare professionals to better guarantee the advantageous impact of RDT technology on the consolidation of the malaria elimination work achievements.

[Evaluation of an optimization strategy for use and management of malaria rapid diagnostic testing (RDT) in Jiangsu Province].

OBJECTIVE: To evaluate the implementation effect of the optimization strategy for the use and management of malaria rapid diagnostic testing (RDT) technology in Jiangsu Province, so as to provide the empirical evidence and suggestions for promoting the standardized use of RDT technology. METHODS: Questionnaire surveys of primary-level health professionals' RDT-related knowledge, attitude, and practice (KAP) and work satisfaction were conducted in 4 pilot cities in Jiangsu Province before and after the intervention. RESULTS: After the implementation of the intervention, 13.9% of surveyed laboratory technicians, 21.9% of surveyed clinicians and 4.1% of surveyed staff of the centers for disease control and prevention (CDCs) had significant improvements in RDT-related knowledge. About 10.9% of the surveyed laboratory technicians and 25.6% of the surveyed CDC staff improved their attitudes toward RDT technology. About 38.4% of the surveyed laboratory technicians and 10.0% of the surveyed clinicians improved the standardized use of RDT technology. All types of primary-level health professionals had high evaluation in the satisfaction and effectiveness of the optimization strategy. However, the evaluation of the surveyed clinicians was slightly lower than that of the laboratory technicians and CDC staff. CONCLUSIONS: The optimization strategy in this project can effectively improve the knowledge, attitude and behavior of all types of primary-level health professionals and help to promote the standardized use of RDT technology.

Evaluation of an optimization strategy for use and management of malaria rapid diagnostic testing (RDT) in Jiangsu Province / 中国血吸虫病防治杂志

To evaluate the implementation effect of the optimization strategy for the use and management of malaria rapid diagnostic testing (RDT) technology in Jiangsu Province, so as to provide the empirical evidence and suggestions for promoting the standardized use of RDT technology.Questionnaire surveys of primary-level health professionals’ RDT-related knowledge, attitude, and practice (KAP) and work satisfaction were conducted in 4 pilot cities in Jiangsu Province before and after the intervention.After the implementation of the intervention, 13.9% of surveyed laboratory technicians, 21.9% of surveyed clinicians and 4.1% of surveyed staff of the centers for disease control and prevention (CDCs) had significant improvements in RDT-related knowledge. About 10.9% of the surveyed laboratory technicians and 25.6% of the surveyed CDC staff improved their attitudes toward RDT technology. About 38.4% of the surveyed laboratory technicians and 10.0% of the surveyed clinicians improved the standardized use of RDT technology. All types of primary-level health professionals had high evaluation in the satisfaction and effectiveness of the optimization strategy. However, the evaluation of the surveyed clinicians was slightly lower than that of the laboratory technicians and CDC staff.The optimization strategy in this project can effectively improve the knowledge, attitude and behavior of all types of primary-level health professionals and help to promote the standardized use of RDT technology.

Investigation on malaria rapid diagnostic testing (RDT) - related knowledge, attitude and practice in primary healthcare professionals of Jiangsu Province / 中国血吸虫病防治杂志

To investigate the malaria rapid diagnostic testing (RDT) - related knowledge, attitude, practice (KAP) of primary healthcare professionals in Jiangsu Province and analyze the corresponding influencing factors.Four cities in Jiangsu Province were selected as the study sites by the typical sampling method to conduct a survey for the RDT related KAP and work satisfaction of primary healthcare professionals, and the multiple logistic regression model was used to explore the relevant influencing factors.Totally 1 150 questionnaires were issued and 949 valid questionnaires were collected with the recovery rate of 82.52%. The valid questionnaires included 453 questionnaires from laboratory technicians, 466 from clinicians, and 30 from malaria prevention and control workers. Totally 83.98% of the surveyed professionals had a low mastering level of essential RDT-related knowledge. A total of 52.17% of the surveyed laboratory technicians recognized that the application of RDT technology could effectively improve the current primary-level microscopy work, and the degree of recognition of RDT technological advantage in the laboratory technicians was higher than that in the clinicians. Totally 79.25% of the surveyed laboratory technicians regarded themselves to be capable of conducting the standardized RDT operation, and 84.55% of the surveyed clinicians regarded themselves to be capable of conducting the qualified malaria clinical diagnostic practice. The key influencing factors of RDT-related KAP of primary healthcare professionals included the laboratory technicians’ gender, educational level, employer’s institutional level, professional title, and working years, and the employer’s institutional level of clinicians.The primary healthcare professionals in Jiangsu Province exhibita good acceptability towards RDT technology. However, their essential knowledge on RDT remains to be improved. Therefore, it is necessary to establish a specific training and educational system for primary healthcare professionals to better guarantee the advantageous impact of RDT technology on the consolidation of the malaria elimination work achievements.