Table 5.

Clinical Outcomes and Antibiotic Utilization in Pathogen Subgroups

Gram-Positive Cocci Bacteremia (Excluding CoNS)CoNS BacteremiaGram-Negative Rod Bacteremia
Outcome and Antibiotic UseHistorical (n = 54)AXDX (n = 46)AXDX + RTN (n = 36)P ValueHistorical (n = 79)AXDX (n = 75)AXDX + RTN (n = 76)P ValueHistorical (n = 50)AXDX (n = 31)AXDX + RTN (n = 33)P Value
LOS
 Hospital LOS 10.3 (6.2–18.2)9.5 (5.9–20.1)7.9 (6.1–13.6) .5677.2 (4.8–11.3)5.5 (3.3–8.9)a4.5 (2.9–9.7)a.0037.7 (4.4–15.0)3.8 (3.1–7.0)a, b8.0 (4.2–14.1).008
 Hospital LOS following culture collection8.3 (5.9–11.0)7.5 (5.1–14.0)7.3 (5.7–11.2).8136.1 (4.1–8.6)4.8 (3.0–7.7)a4.2 (2.9–7.3)a.0266.8 (4.4–10.5)3.8 (3.0–6.9)a5.5 (4.0–10.8).014
 ICU LOS4.7 (2.0–10.7)6.0 (1.6–9.4)4.5 (3.1–6.7).8662.0 (0.9–3.7)2.6 (1.4–4.1)2.1 (1.4–3.2).3132.8 (1.6–6.5)1.9 (1.4–5.0)2.8 (1.6–4.0).864
 ICU LOS following culture collection3.5 (1.7–6.2)3.0 (4.6–9.4)4.7 (3.1–5.5).7281.6 (0.9–3.5)2.2 (1.3–4.0)2.0 (1.0–2.9).6062.7 (1.6–3.8)1.9 (1.4–5.0)2.8 (1.6–4.0).898
Optimal therapy
 Achieved optimal therapy, No. (%) 51 (94.4)43 (93.5)36 (100.0).31762 (78.5)71 (94.7)a71 (93.4)a.00242 (82.0)28 (90.3)31 (93.9).238
 TTOT following culture collection2.8 (1.9–3.4)1.8 (0.8–2.8)a1.5 (1.1–1.9)a≤ .0012.9 (0.5–3.5)1.3 (0.0–2.3)a1.0 (0.0–2.0)a≤ .0013.2 (2.2–3.9)1.4 (0.5–2.0)a1.5 (1.0–2.1)a≤ .001
CDI within 90 d, No. (%) 2 (3.7)1 (2.2)3 (8.3).3851 (1.3)4 (5.3)5 (6.6).2372 (4.0)3 (9.7)4 (12.1).373
In-hospital transition to hospice care, No. (%)4 (7.4)7 (15.2)2 (5.6).2676 (7.6)4 (5.3)4 (5.3).7882 (4.0)4 (12.9)2 (6.1).306
In-hospital mortality, No. (%)5 (9.3)7 (15.2)2 (5.6).3456 (7.6)2 (2.7)4 (5.3).3904 (8.0)2 (6.5)4 (12.1).704
Antibiotic use
 Total antibiotic use8 (7–12)9 (6–14)8 (6–12).9136 (4–9)5 (2–7)4 (3–7).0608 (5–11)5 (4–8)a,b6 (5–12).007
  BGP4 (2–7)5 (2–9)4 (2–7).8454 (2–6)3 (1–6)a2 (1–4)a.0032 (0–4)2 (1–3)1 (0–4).719
   Vancomycin3 (2–6)4 (2–9)4 (2–7).9975 (3–7)3 (2–7)3 (2–4)a.0022 (1–4)2 (1–3)2 (1–6).438
  BGN4 (2–6)4 (1–6)3 (2–5).6364 (1–7)2 (0–7)3 (0–5)a.0467 (4–10)4 (2–7)a5 (2–8)a.028
  NBL3 (0–8)4 (0–6)4 (1–7).7490 (0–1)0 (0–2)a0 (0–2)a.0101 (0–4)0 (0–2) b3 (2–5)a.001
Gram-Positive Cocci Bacteremia (Excluding CoNS)CoNS BacteremiaGram-Negative Rod Bacteremia
Outcome and Antibiotic UseHistorical (n = 54)AXDX (n = 46)AXDX + RTN (n = 36)P ValueHistorical (n = 79)AXDX (n = 75)AXDX + RTN (n = 76)P ValueHistorical (n = 50)AXDX (n = 31)AXDX + RTN (n = 33)P Value
LOS
 Hospital LOS 10.3 (6.2–18.2)9.5 (5.9–20.1)7.9 (6.1–13.6) .5677.2 (4.8–11.3)5.5 (3.3–8.9)a4.5 (2.9–9.7)a.0037.7 (4.4–15.0)3.8 (3.1–7.0)a, b8.0 (4.2–14.1).008
 Hospital LOS following culture collection8.3 (5.9–11.0)7.5 (5.1–14.0)7.3 (5.7–11.2).8136.1 (4.1–8.6)4.8 (3.0–7.7)a4.2 (2.9–7.3)a.0266.8 (4.4–10.5)3.8 (3.0–6.9)a5.5 (4.0–10.8).014
 ICU LOS4.7 (2.0–10.7)6.0 (1.6–9.4)4.5 (3.1–6.7).8662.0 (0.9–3.7)2.6 (1.4–4.1)2.1 (1.4–3.2).3132.8 (1.6–6.5)1.9 (1.4–5.0)2.8 (1.6–4.0).864
 ICU LOS following culture collection3.5 (1.7–6.2)3.0 (4.6–9.4)4.7 (3.1–5.5).7281.6 (0.9–3.5)2.2 (1.3–4.0)2.0 (1.0–2.9).6062.7 (1.6–3.8)1.9 (1.4–5.0)2.8 (1.6–4.0).898
Optimal therapy
 Achieved optimal therapy, No. (%) 51 (94.4)43 (93.5)36 (100.0).31762 (78.5)71 (94.7)a71 (93.4)a.00242 (82.0)28 (90.3)31 (93.9).238
 TTOT following culture collection2.8 (1.9–3.4)1.8 (0.8–2.8)a1.5 (1.1–1.9)a≤ .0012.9 (0.5–3.5)1.3 (0.0–2.3)a1.0 (0.0–2.0)a≤ .0013.2 (2.2–3.9)1.4 (0.5–2.0)a1.5 (1.0–2.1)a≤ .001
CDI within 90 d, No. (%) 2 (3.7)1 (2.2)3 (8.3).3851 (1.3)4 (5.3)5 (6.6).2372 (4.0)3 (9.7)4 (12.1).373
In-hospital transition to hospice care, No. (%)4 (7.4)7 (15.2)2 (5.6).2676 (7.6)4 (5.3)4 (5.3).7882 (4.0)4 (12.9)2 (6.1).306
In-hospital mortality, No. (%)5 (9.3)7 (15.2)2 (5.6).3456 (7.6)2 (2.7)4 (5.3).3904 (8.0)2 (6.5)4 (12.1).704
Antibiotic use
 Total antibiotic use8 (7–12)9 (6–14)8 (6–12).9136 (4–9)5 (2–7)4 (3–7).0608 (5–11)5 (4–8)a,b6 (5–12).007
  BGP4 (2–7)5 (2–9)4 (2–7).8454 (2–6)3 (1–6)a2 (1–4)a.0032 (0–4)2 (1–3)1 (0–4).719
   Vancomycin3 (2–6)4 (2–9)4 (2–7).9975 (3–7)3 (2–7)3 (2–4)a.0022 (1–4)2 (1–3)2 (1–6).438
  BGN4 (2–6)4 (1–6)3 (2–5).6364 (1–7)2 (0–7)3 (0–5)a.0467 (4–10)4 (2–7)a5 (2–8)a.028
  NBL3 (0–8)4 (0–6)4 (1–7).7490 (0–1)0 (0–2)a0 (0–2)a.0101 (0–4)0 (0–2) b3 (2–5)a.001

Data presented as median days (interquartile range) unless otherwise indicated. Statistically significant values are highlighted in bold (P ≤ .05). The Candida subgroup analysis was not included due to low incidence.

Abbreviations: AXDX, Accelerate Pheno system; BGN, broad gram negative; BGP, broad gram positive; CDI, Clostridioides difficile infection; CoNS, coagulase-negative staphylococci; ICU, intensive care unit; LOS, length of stay; NBL, narrow β-lactam; RTN, real-time notification; TTOT, time to optimal therapy.

aStatistically significant (P ≤ .05) compared to historical cohort.

bStatistically significant (P ≤ .05) compared to the AXDX-RTN cohort.

Table 5.

Clinical Outcomes and Antibiotic Utilization in Pathogen Subgroups

Gram-Positive Cocci Bacteremia (Excluding CoNS)CoNS BacteremiaGram-Negative Rod Bacteremia
Outcome and Antibiotic UseHistorical (n = 54)AXDX (n = 46)AXDX + RTN (n = 36)P ValueHistorical (n = 79)AXDX (n = 75)AXDX + RTN (n = 76)P ValueHistorical (n = 50)AXDX (n = 31)AXDX + RTN (n = 33)P Value
LOS
 Hospital LOS 10.3 (6.2–18.2)9.5 (5.9–20.1)7.9 (6.1–13.6) .5677.2 (4.8–11.3)5.5 (3.3–8.9)a4.5 (2.9–9.7)a.0037.7 (4.4–15.0)3.8 (3.1–7.0)a, b8.0 (4.2–14.1).008
 Hospital LOS following culture collection8.3 (5.9–11.0)7.5 (5.1–14.0)7.3 (5.7–11.2).8136.1 (4.1–8.6)4.8 (3.0–7.7)a4.2 (2.9–7.3)a.0266.8 (4.4–10.5)3.8 (3.0–6.9)a5.5 (4.0–10.8).014
 ICU LOS4.7 (2.0–10.7)6.0 (1.6–9.4)4.5 (3.1–6.7).8662.0 (0.9–3.7)2.6 (1.4–4.1)2.1 (1.4–3.2).3132.8 (1.6–6.5)1.9 (1.4–5.0)2.8 (1.6–4.0).864
 ICU LOS following culture collection3.5 (1.7–6.2)3.0 (4.6–9.4)4.7 (3.1–5.5).7281.6 (0.9–3.5)2.2 (1.3–4.0)2.0 (1.0–2.9).6062.7 (1.6–3.8)1.9 (1.4–5.0)2.8 (1.6–4.0).898
Optimal therapy
 Achieved optimal therapy, No. (%) 51 (94.4)43 (93.5)36 (100.0).31762 (78.5)71 (94.7)a71 (93.4)a.00242 (82.0)28 (90.3)31 (93.9).238
 TTOT following culture collection2.8 (1.9–3.4)1.8 (0.8–2.8)a1.5 (1.1–1.9)a≤ .0012.9 (0.5–3.5)1.3 (0.0–2.3)a1.0 (0.0–2.0)a≤ .0013.2 (2.2–3.9)1.4 (0.5–2.0)a1.5 (1.0–2.1)a≤ .001
CDI within 90 d, No. (%) 2 (3.7)1 (2.2)3 (8.3).3851 (1.3)4 (5.3)5 (6.6).2372 (4.0)3 (9.7)4 (12.1).373
In-hospital transition to hospice care, No. (%)4 (7.4)7 (15.2)2 (5.6).2676 (7.6)4 (5.3)4 (5.3).7882 (4.0)4 (12.9)2 (6.1).306
In-hospital mortality, No. (%)5 (9.3)7 (15.2)2 (5.6).3456 (7.6)2 (2.7)4 (5.3).3904 (8.0)2 (6.5)4 (12.1).704
Antibiotic use
 Total antibiotic use8 (7–12)9 (6–14)8 (6–12).9136 (4–9)5 (2–7)4 (3–7).0608 (5–11)5 (4–8)a,b6 (5–12).007
  BGP4 (2–7)5 (2–9)4 (2–7).8454 (2–6)3 (1–6)a2 (1–4)a.0032 (0–4)2 (1–3)1 (0–4).719
   Vancomycin3 (2–6)4 (2–9)4 (2–7).9975 (3–7)3 (2–7)3 (2–4)a.0022 (1–4)2 (1–3)2 (1–6).438
  BGN4 (2–6)4 (1–6)3 (2–5).6364 (1–7)2 (0–7)3 (0–5)a.0467 (4–10)4 (2–7)a5 (2–8)a.028
  NBL3 (0–8)4 (0–6)4 (1–7).7490 (0–1)0 (0–2)a0 (0–2)a.0101 (0–4)0 (0–2) b3 (2–5)a.001
Gram-Positive Cocci Bacteremia (Excluding CoNS)CoNS BacteremiaGram-Negative Rod Bacteremia
Outcome and Antibiotic UseHistorical (n = 54)AXDX (n = 46)AXDX + RTN (n = 36)P ValueHistorical (n = 79)AXDX (n = 75)AXDX + RTN (n = 76)P ValueHistorical (n = 50)AXDX (n = 31)AXDX + RTN (n = 33)P Value
LOS
 Hospital LOS 10.3 (6.2–18.2)9.5 (5.9–20.1)7.9 (6.1–13.6) .5677.2 (4.8–11.3)5.5 (3.3–8.9)a4.5 (2.9–9.7)a.0037.7 (4.4–15.0)3.8 (3.1–7.0)a, b8.0 (4.2–14.1).008
 Hospital LOS following culture collection8.3 (5.9–11.0)7.5 (5.1–14.0)7.3 (5.7–11.2).8136.1 (4.1–8.6)4.8 (3.0–7.7)a4.2 (2.9–7.3)a.0266.8 (4.4–10.5)3.8 (3.0–6.9)a5.5 (4.0–10.8).014
 ICU LOS4.7 (2.0–10.7)6.0 (1.6–9.4)4.5 (3.1–6.7).8662.0 (0.9–3.7)2.6 (1.4–4.1)2.1 (1.4–3.2).3132.8 (1.6–6.5)1.9 (1.4–5.0)2.8 (1.6–4.0).864
 ICU LOS following culture collection3.5 (1.7–6.2)3.0 (4.6–9.4)4.7 (3.1–5.5).7281.6 (0.9–3.5)2.2 (1.3–4.0)2.0 (1.0–2.9).6062.7 (1.6–3.8)1.9 (1.4–5.0)2.8 (1.6–4.0).898
Optimal therapy
 Achieved optimal therapy, No. (%) 51 (94.4)43 (93.5)36 (100.0).31762 (78.5)71 (94.7)a71 (93.4)a.00242 (82.0)28 (90.3)31 (93.9).238
 TTOT following culture collection2.8 (1.9–3.4)1.8 (0.8–2.8)a1.5 (1.1–1.9)a≤ .0012.9 (0.5–3.5)1.3 (0.0–2.3)a1.0 (0.0–2.0)a≤ .0013.2 (2.2–3.9)1.4 (0.5–2.0)a1.5 (1.0–2.1)a≤ .001
CDI within 90 d, No. (%) 2 (3.7)1 (2.2)3 (8.3).3851 (1.3)4 (5.3)5 (6.6).2372 (4.0)3 (9.7)4 (12.1).373
In-hospital transition to hospice care, No. (%)4 (7.4)7 (15.2)2 (5.6).2676 (7.6)4 (5.3)4 (5.3).7882 (4.0)4 (12.9)2 (6.1).306
In-hospital mortality, No. (%)5 (9.3)7 (15.2)2 (5.6).3456 (7.6)2 (2.7)4 (5.3).3904 (8.0)2 (6.5)4 (12.1).704
Antibiotic use
 Total antibiotic use8 (7–12)9 (6–14)8 (6–12).9136 (4–9)5 (2–7)4 (3–7).0608 (5–11)5 (4–8)a,b6 (5–12).007
  BGP4 (2–7)5 (2–9)4 (2–7).8454 (2–6)3 (1–6)a2 (1–4)a.0032 (0–4)2 (1–3)1 (0–4).719
   Vancomycin3 (2–6)4 (2–9)4 (2–7).9975 (3–7)3 (2–7)3 (2–4)a.0022 (1–4)2 (1–3)2 (1–6).438
  BGN4 (2–6)4 (1–6)3 (2–5).6364 (1–7)2 (0–7)3 (0–5)a.0467 (4–10)4 (2–7)a5 (2–8)a.028
  NBL3 (0–8)4 (0–6)4 (1–7).7490 (0–1)0 (0–2)a0 (0–2)a.0101 (0–4)0 (0–2) b3 (2–5)a.001

Data presented as median days (interquartile range) unless otherwise indicated. Statistically significant values are highlighted in bold (P ≤ .05). The Candida subgroup analysis was not included due to low incidence.

Abbreviations: AXDX, Accelerate Pheno system; BGN, broad gram negative; BGP, broad gram positive; CDI, Clostridioides difficile infection; CoNS, coagulase-negative staphylococci; ICU, intensive care unit; LOS, length of stay; NBL, narrow β-lactam; RTN, real-time notification; TTOT, time to optimal therapy.

aStatistically significant (P ≤ .05) compared to historical cohort.

bStatistically significant (P ≤ .05) compared to the AXDX-RTN cohort.

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