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Need for Therapeutic Guidance With Antimicrobial Resistance Test Results

Clinicians could benefit from interpretative comments and therapeutic guidance when presented with rapid diagnostic culture results and antimicrobial resistance (AMR) information, according to results of a survey conducted by the Antibacterial Resistance Leadership Group Diagnostics Committee. “Current approaches to reporting molecular AMR test results from positive blood culture vary significantly across clinical laboratories,” the authors conclude. “Providing interpretative comments with therapeutic guidance alongside results reported may assist clinicians who are not well-versed in genetic mechanisms of AMR. However, this is currently not being done in all clinical laboratories. Standardized strategies for AMR gene result reporting are needed.”

The survey, conducted from Dec. 2022 to May 2021, was distributed to local hospitals, shared on the ClinMicroNet and Division C listservs, and included in a College of American Pathologists proficiency testing survey. “Ninety-six laboratories of various sizes across the United States (95%) and outside of the United States (5%) participated,” the authors report. “Of the laboratories that had at least 1 rapid diagnostic in place (94%), significant heterogeneity in methods used and reporting practices was found across community (52%) and academic (40%) laboratories serving hospitals of various sizes. Respondents had implemented 1 to 6 different panels/platforms for a total of 31 permutations. Methods of reporting rapid organism identification and AMR results varied from listing all targets as ‘detected’/’not detected’ (16–22%) without interpretive guidance, to interpreting results (23–42%), or providing therapeutic guidance comments to patient-facing healthcare teams (3–17%).”

Source: Clinical Infectious Diseases