Students Research in Progress
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction:
Infections are common in the intensive care unit (ICU), but concerns for increasing antimicrobial resistance worldwide make it prudent to implement antimicrobial stewardship (AMS) practices. While broad spectrum antibiotics are typically warranted empirically in critical care, timely de-escalation is necessary. A typical infectious workup includes obtaining cultures from potential sites of infection, followed by gram staining, microbial growth, and antimicrobial susceptibility testing. Gram stain results are typically available within 24 hours, whereas culture and sensitivity results may take 72 hours or more. The value of gram stain results in antibiotic initiation has been established, but not de-escalation. Exploring the utility of gram staining for early antibiotic de-escalation has the potential for reducing antibiotic use, preventing antibiotic-associated adverse events and secondary infections, and substantial cost savings.
Research Question or Hypothesis: To determine the frequency that gram stain results are reflective of final culture results.
Study Design: Retrospective, quantitative analysis
Methods: The primary objective is to determine the reliability of gram staining results as a standalone tool. This retrospective chart review is being conducted at the University of South Alabama University Hospital. Patients were identified by an electronic health record search for all patients admitted to the surgical-trauma ICU from January 1 through December 31, 2022, who received an infectious workup including a bacterial gram stain and culture. Gram stain results will be compared to microbial growth results to determine their predictive accuracy. Results will be described as frequencies and percentages for categorical data and means or medians with standard deviations or interquartile ranges for numerical data, as appropriate. SPSS will be utilized for statistical analysis.
Results: Preliminary results are in progress. A total of 113 patients have been identified for inclusion.
Conclusion: The results will be used to promote earlier de-escalation in the surgical-trauma ICU.
Presenting Author
Sarah Grace Cook BS, PharmD Candidate 2024Auburn University
Authors
Ashley Hawthorne PharmD
Auburn University
Angelique Holmes BS, PharmD Candidate 2024
Auburn University