Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Provider perceptions of an antimicrobial stewardship program in immunocompromised patients at a cancer center.","authors":"Raneem H Pallotta, Julia E Szymczak, Emily S Spivak, Hannah Imlay","doi":"10.1017/ash.2026.10756","DOIUrl":"10.1017/ash.2026.10756","url":null,"abstract":"<p><p>Although provider opposition has been identified as a barrier to initiating antimicrobial stewardship programs (ASPs) among immunocompromised (IC) patients, little is known about perceptions of IC ASPs postimplementation. We assessed provider perceptions of our cancer hospital-focused ASP. Respondents found the ASP to be acceptable and value-added.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e197"},"PeriodicalIF":0.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost to implement an outpatient stewardship intervention for acute otitis media (AOM).","authors":"Leisha M Andersen, Sophie E Katz, Amy Keith, Theresa L Morin, Timothy C Jenkins, Alexander S Plattner, Evan Facer, Sherry Dodd, Sharon Graham, Holly M Frost","doi":"10.1017/ash.2026.10428","DOIUrl":"10.1017/ash.2026.10428","url":null,"abstract":"<p><strong>Objective: </strong>Most children 2 years and older with uncomplicated acute otitis media (AOM) are prescribed 10-day antibiotic durations, despite national guidelines recommending antibiotics for 5-7 days. Costs are often cited as a barrier to stewardship efforts. As part of a larger clinical trial including 2 systems and 46 clinics, we developed a low-intensity and a high-intensity intervention aimed at reducing antibiotic duration for AOM and evaluated implementation and sustainability for the interventions.</p><p><strong>Methods: </strong>Costs associated with each implementation activity were recorded over time, including material/supply costs (eg, printing) and personnel time costs. Sustainability costs were estimated based on ongoing implementation expenses. For each system, we assessed total intervention, activity-specific, and sustainability costs. Aggregate results were reported as the median across systems.</p><p><strong>Results: </strong>The total median implementation costs were $3,606 (range $2,540-$4,672) for the low-intensity intervention and $9,203 (range $7,557-$10,849) for the high-intensity intervention. For the low-intensity intervention, the primary cost driver was electronic health record modifications totaling $2,292 (range $1,615-$2,968). For the high-intensity intervention, the primary cost driver was audit and feedback system activation totaling $5,597 (range $2,885-$8,309). Personnel time accounted for over 90% of costs in both study arms. Sustainability costs were $133/year (range $77-$190) for the low-intensity intervention and $764/year (range $628-$901) for the high-intensity intervention.</p><p><strong>Conclusions: </strong>Overall costs were low. The high-intensity intervention resulted in higher costs compared to the low-intensity intervention.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e171"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing antimicrobial stewardship programs in retirement homes: a quality improvement pilot using prospective audit and feedback.","authors":"Dan Dalton, Denis O'Donnell, Valerie Leung, Kevin A Brown, Nick Daneman, Stephana Hung, Kevin L Schwartz, Michelle K Wong, Bradley J Langford","doi":"10.1017/ash.2026.10744","DOIUrl":"10.1017/ash.2026.10744","url":null,"abstract":"<p><strong>Background: </strong>Little is known about implementation of antimicrobial stewardship (AMS) programs in retirement homes, a setting with an older adult population which is at increased risk of antibiotic-related harm. This study evaluated a pharmacist-led prospective audit and feedback (PAF) pilot program in retirement homes.</p><p><strong>Methods: </strong>This quasi-experimental study evaluated antibiotic use in 9 intervention homes and 396 control homes from June 2022 to May 2023 (baseline period), compared to June 2023 to December 2024 (intervention period). PAF was conducted remotely by long-term care pharmacists; recommendations were provided to the prescriber via fax. The primary outcome was antibiotic days of therapy (DOT) per 1000 resident-days. Determinants to implementation were gathered from participating pharmacists and mapped to the Theoretical Domains Framework.</p><p><strong>Results: </strong>During the intervention, of 794 antibiotic assessments, 89 recommendations were made and 27 (30%) were accepted. Total antibiotic use measured in DOT per 1,000 resident days in intervention homes was similar before and after PAF (54.0 before vs. 57.9 after). Similarly, usage in the control group was relatively stable (49.0 before vs. 51.6 after) (DiD Analysis: +2.4 DOT/1,000 resident days, 95% CI -7.8, 12.3). Barriers to PAF implementation included communication challenges (communication via fax) and limited clinical information (lack of indication on prescription). Facilitators included organizational support and pharmacist motivation.</p><p><strong>Conclusions: </strong>While this pilot had limited uptake and was not associated with a change in antibiotic use, it highlighted important barriers and facilitators for AMS in retirement homes. This initiative strengthened local capabilities for antibiotic use surveillance to support future AMS interventions.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e194"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare-associated parechovirus-A infection in hospitals with neonatal units in Japan: a nationwide survey.","authors":"Yuta Aizawa, Ichiro Morioka, Naoto Takahashi, Akihiko Saitoh","doi":"10.1017/ash.2026.10408","DOIUrl":"10.1017/ash.2026.10408","url":null,"abstract":"<p><strong>Objective: </strong>To determine the scope and characteristics of healthcare-associated parechovirus-A infection (HA-PI).</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>Hospitals with neonatal units in Japan.</p><p><strong>Participants: </strong>Patients with parechovirus-A infection in 2023 in Japan.</p><p><strong>Methods: </strong>A 2-step questionnaire survey included the primary survey ascertaining the number of patients with HA-PI in 2023, followed by the secondary survey investigating the details of the patients with HA-PI.</p><p><strong>Results: </strong>Of the 408 hospitals, 226 (55.4%) responded. Seven sporadic patients were reported from 6 (2.7%) hospitals between May and September 2023, diagnosed as having sepsis (n = 5) or sepsis-like illness (n = 2). The median gestational age was 37.7 weeks (IQR, 36.2-38.3). They were second-born (n = 6) or third-born (n = 1), without first-born. The median days of onset of illness were 7 days (IQR, 6-15). The locations were the newborn nursery (n = 3), growth care (n = 3), or neonatal intensive care units (n = 1). No sequelae were found at least 10 months in all patients. Parechovirus-A genotype analyses demonstrated A3 (n = 6) and unknown (n = 1). The identified sources of infection were from the mother (n = 5) or unknown (n = 2). Among the 5 mothers, 2 were symptomatic. Notably, the siblings of patients in 3 asymptomatic mothers, who had no direct contact with the patients, were all symptomatic.</p><p><strong>Conclusions: </strong>This nationwide survey in Japan demonstrated HA-PI can occur in neonatal units, with potential risks for nosocomial outbreaks. Suspecting HA-PI and preventive measures are critical in neonatal units.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e191"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency department urine culture stewardship and downstream outcomes: a covariate-adjusted biweekly interrupted time series analysis.","authors":"James Howard Acuff, Ashwini Gotimukul, Ganesh Srinivasan Krishnamurthi, Todd Lasco, Armando Rafael Cecilio Leon Silva, D'Feau Jia Lieu, Kady Phe, Sabra L Shay, Alfonso Francisco Siu, Nicholas Teran, Mayar Al Mohajer","doi":"10.1017/ash.2026.10758","DOIUrl":"10.1017/ash.2026.10758","url":null,"abstract":"<p><strong>Background: </strong>Emergency department (ED) urine culture stewardship may reduce low-value testing, but downstream effects on antibiotic use and postdischarge utilization remain uncertain.</p><p><strong>Methods: </strong>We evaluated an intervention in which an infectious diseases physician and microbiologist reviewed pyuric urinalysis-with-reflex encounters, assessed culture indications, and contacted clinicians to recommend cancellation when absent. Adult ED encounters from February-July 2025 to September 2025-February 2026 were included; August was washout. Outcomes were urinalysis with reflex within 24 hours, urine culture within 24 hours, antibiotic days of therapy (DOT) per 100 patient-days, length of stay (LOS), and 30-day ED revisit among ED discharges. We fit biweekly interrupted time series models.</p><p><strong>Results: </strong>Among 17,621 encounters, the intervention was associated with lower postintervention slopes for urinalysis with reflex within 24 hours (-0.5 percentage points per biweekly period; 95% CI, -0.9 to -0.1) and urine culture within 24 hours (-0.2 percentage points; 95% CI, -0.4 to -0.0). DOT showed no sustained change (postintervention slope change, 0.00; 95% CI, -0.23 to 0.24). LOS showed a lower postintervention slope (-0.05 d; 95% CI, -0.08 to -0.02). Thirty-day ED revisit showed a higher postintervention slope (0.8 percentage points; 95% CI, 0.3 to 1.3).</p><p><strong>Conclusions: </strong>The intervention reduced urinary testing but did not reduce antibiotic DOT and was associated with increased 30-day ED revisit. Diagnostic stewardship in the ED may need to be paired with antimicrobial stewardship and prospective safety monitoring.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e196"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of treatment outcomes in patients receiving high- versus low-dose sulfamethoxazole-trimethoprim for oral stepdown therapy in gram-negative bacteremia: a multi-center, retrospective cohort study.","authors":"Jordan Jones, Rachel B Colven, Taylor Morrisette, Krutika Mediwala Hornback, Lindsay Deloney, Zachary Gruss, Gustavo Alvira-Arill, Tracie Delay, Aaron Hamby","doi":"10.1017/ash.2026.10771","DOIUrl":"10.1017/ash.2026.10771","url":null,"abstract":"<p><strong>Objective: </strong>Many studies have evaluated the safety and efficacy of oral stepdown therapy for treatment of gram-negative bacteremia (GNB). There are currently no studies comparing the safety and effectiveness of various dosing strategies of sulfamethoxazole-trimethoprim (SMX-TMP) in these patients.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients at 6 hospitals within a health system with GNB, excluding <i>Stenotrophomonas spp.</i> that received at least 72 hours of oral SMX-TMP. Patients were grouped based on high- (≥8 mg/kg) or low-dose (<8 mg/kg) SMX-TMP. The primary outcome was a composite of all-cause mortality and recurrence at 30 days. Secondary outcomes included readmission, hyperkalemia requiring intervention, acute kidney injury, and intolerance leading to SMX-TMP discontinuation.</p><p><strong>Results: </strong>There were 176 patients included (25.6% high-dose, 74.4% low-dose) in this study. Baseline characteristics were similar except for age, sex, and dosing body weight. Median total duration of therapy for both groups was approximately 14 days; time to initiation of antibiotics was similar between groups. Six patients met the composite outcome (high-dose: 4.4% vs. low-dose: 3.1%; <i>P</i> = .646). Secondary outcomes did not differ significantly between groups.</p><p><strong>Conclusions: </strong>SMX-TMP is commonly used as oral stepdown therapy in GNB. Results of this study indicate that low-dose (<8 mg/kg) SMX-TMP may be sufficient, as outcomes were similar between the groups. To date, this is the first study evaluating different dosing strategies of SMX-TMP for this indication.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e195"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of technology and disparities in antimicrobial stewardship: a narrative review.","authors":"Christina Maguire, Ryan T Clary, Oluchi Mbamalu, Jihye Kim, Kimberly B Lee, Andrew Noda, Megan Backus, Barry Rittmann, Sangeeta Sastry","doi":"10.1017/ash.2026.10404","DOIUrl":"10.1017/ash.2026.10404","url":null,"abstract":"<p><p>The number of resources devoted to antimicrobial stewardship programs (ASPs) has grown over the past thirty years as multidrug-resistant organism rates have increased. Technology plays a pivotal role in ASP expansion and allows for further reach, higher-yield initiatives, and improved patient safety and efficacy. This review highlights major technological innovations that have shaped ASPs over time and addresses the future of incorporating artificial intelligence into everyday ASP workflow. We discuss the current state of ASP technology in low- and middle-income countries with a focus on challenges and suggested solutions to incorporating artificial intelligence internationally. Bridging the global digital and technological divide through investments in resources (human capacity, infrastructure, and supporting environment) is vital to sustain progress against antimicrobial resistance.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e190"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulatory antibiotic prescribing for acute sinusitis: a multicenter, retrospective cohort study evaluating appropriateness.","authors":"Kellie Arensman Hannan, Dan Ilges, Kimberly T Le, Kristin Cole, Ryan W Stevens, Kelsey Jensen","doi":"10.1017/ash.2026.10743","DOIUrl":"10.1017/ash.2026.10743","url":null,"abstract":"<p><strong>Objective: </strong>Antibiotics are frequently prescribed for acute sinusitis despite national guidelines recommending antibiotics only if specific symptom criteria are met. We aimed to define the proportion of acute sinusitis encounters meeting criteria for antibiotic prescribing, characterize prescribing practices, and identify factors associated with guideline-discordant prescribing.</p><p><strong>Design: </strong>This retrospective cohort study included 1,000 randomly selected adult ambulatory encounters with a primary diagnosis of acute sinusitis between January 1, 2024 and March 31, 2024. Encounter notes were reviewed for appropriate antibiotic prescribing criteria as per national guidelines. Encounters were evaluated for drug selection and duration concordance based on local guidelines. A multivariable logistic regression analysis was performed to identify predictors of inappropriate antibiotic prescribing.</p><p><strong>Setting: </strong>Emergency departments, urgent care centers, and primary care clinics.</p><p><strong>Results: </strong>Antibiotic prescribing criteria were met for 67.6% of included encounters. Antibiotics were prescribed in 93.5% of encounters that met prescribing criteria, and 80.2% of encounters that did not. Both drug selection and duration were guideline-concordant in 49.2% of total encounters. On multivariable analysis, predictors of inappropriate antibiotic prescribing included cough (OR 2.15, 95% CI 1.08-4.29; <i>P</i> = 0.03) and symptom duration between 7 and 9 days (compared to <6 days; OR 7.70, 95% CI 3.24-18.31; <i>P</i> < 0.001). Electronic encounters were associated with lower odds of prescribing compared to in-person encounters (OR 0.03, 95% CI 0.01-0.09; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Most encounters for acute sinusitis result in an antibiotic prescription, despite prescribing criteria not being met. These findings may aid antimicrobial stewardship programs in benchmarking and optimizing antibiotic prescribing for acute sinusitis.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e193"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidural anesthesia not associated with decreased 30-day surgical site infection occurrence after open colorectal surgery.","authors":"Matthew Smith, Jackson Prestwood, Krista Highland, Matthew Nealeigh, Tiger Lindsay, Kayla Knuf","doi":"10.1017/ash.2026.10426","DOIUrl":"10.1017/ash.2026.10426","url":null,"abstract":"<p><strong>Objective: </strong>Surgical site infections (SSI) after colorectal surgery are common. Epidural anesthesia (EA) has demonstrated multiple beneficial effects for patients undergoing open colorectal surgery. However, research regarding the relationship between EA and SSI after open colorectal surgery remains limited.</p><p><strong>Methods: </strong>This retrospective study analyzed 2022-2023 data from the American College of Surgeons National Surgical Quality Improvement Project registry. Patients were included if they received a colorectal procedure without additional minor or major therapeutic procedures. Generalized additive models evaluated 30-day occurrence of any SSI (primary outcome), as well as incisional SSI and organ-space SSI (secondary outcomes). A sensitivity analysis of the primary outcome incorporated propensity score weighting to account for treatment selection.</p><p><strong>Results: </strong>Of the 6,343 patients included in the data set, 1,495 (24%) received EA and 3,391 (53%) received colorectal resection. EA was not significantly associated with any SSI (OR 1.11, 95% confidence interval (CI) 0.93-1.33, P = .26), superficial/deep incisional SSI (OR = 1.24, 95% CI 0.96-1.61, P = .11), or organ-space SSI (OR 1.00, 95% CI 0.80-1.25, P = .98). The primary findings were consistent in the sensitivity analysis (OR 0.91, 95% CI 0.77-1.08, P = .27). Patients undergoing enterostomy procedures were more likely to experience all three SSI outcomes relative to those who received colorectal resections without enterostomies.</p><p><strong>Conclusion: </strong>There was a lack of significant differences in the odds of SSI between patients who did and did not receive EA for elective open colorectal surgery.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e192"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of rapid molecular testing on clinical outcomes for methicillin-susceptible <i>Staphylococcus aureus</i> bacteremia.","authors":"Jay Olivet, Matthew L Brown, Megan Amerson-Brown, W Seth Edwards, Robert A Oster, Joshua Stripling","doi":"10.1017/ash.2026.10749","DOIUrl":"10.1017/ash.2026.10749","url":null,"abstract":"<p><strong>Background: </strong>Rapid molecular blood culture identification (BCID) enables earlier pathogen identification and targeted antibiotic therapy compared with traditional culture-based methods. Methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA) bacteremia is optimally treated with anti-staphylococcal β-lactam antibiotics; however, delays in bacterial identification frequently result in prolonged empiric anti-methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) therapy. Data evaluating the clinical impact of early MSSA identification remain limited.</p><p><strong>Methods: </strong>This retrospective, single-center, quasi-experimental program evaluation included adult patients with monomicrobial MSSA bacteremia. Patients were grouped based on identification by BCID or conventional culture-based methods. Automatic Infectious Diseases consultation was performed for all patients. The primary outcome was a desirability of outcome ranking incorporating treatment success, acute kidney injury (AKI), and inpatient mortality. Secondary outcomes included time-to-optimal therapy, duration of bacteremia, treatment success, and hospital length of stay.</p><p><strong>Results: </strong>A total of 300 patients were included (150 per cohort). BCID use was associated with earlier MSSA identification (0.8 vs 2.1 days; <i>P</i> < .001) and earlier initiation of targeted β-lactam therapy (1.9 vs 3.8 days; <i>P</i> < .001). The probability of a more desirable outcome with BCID was 58.5% (95% CI: 52.5% to 64.3%), and more individuals achieved the most desirable outcome (62.0% vs 46.0%; <i>P</i> = .005). AKI occurred less frequently in the BCID group (23.5% vs 44.2%; <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Incorporation of rapid BCID into an established automatic Infectious Diseases consultation program improved outcomes in MSSA bacteremia by facilitating earlier β-lactam therapy and reducing nephrotoxicity. Antimicrobial stewardship programs should prioritize rapid diagnostics to optimize MSSA management.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e182"},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}