P-815. Clinical Impact of BioFire® Blood Culture Identification 2 Implementation in Patients with Staphylococcal Bacteremia

Abstract Background The BioFire® Blood Culture Identification 2 (BCID2) PCR panel aids in rapid identification of blood pathogens, including coagulase-negative Staphylococci (CoNS) and methicillin susceptible Staphylococcus aureus (MSSA). BCID2 was implemented at all Hartford HealthCare hospitals in September 2022. The objective of this study was to evaluate how BCID2 impacted vancomycin use, clinical outcomes, and pharmacist intervention. Methods This was a multi-center, retrospective study of adult patients admitted to Hartford HealthCare hospitals with MSSA or CoNS positive blood cultures. The primary endpoint, days of vancomycin therapy, was compared between the pre- (3/7/22 – 9/7/22) and post-BCID2 periods (10/7/22 – 4/7/23). Secondary endpoints included duration of MSSA positive blood cultures, intensive care unit (ICU) length of stay, hospital mortality, and pharmacist interventions accepted. Results Of the 617 patients included in the primary analysis, MSSA bacteremia accounted for 37.0% (110/297) and 31.6% (101/320) of the patients in the pre- and post-BCID2 group, respectively (p=0.178). The median duration of vancomycin was 1.3 and 0.3 days in the pre- and post-BCID2 group, respectively (absolute difference, 1.0 days; p< 0.001). The duration of MSSA BSI was 3.1 and 2.4 days in the pre- and post-BCID2 group, respectively (absolute difference, 0.7 days; p=0.096). Hospital mortality was not different between periods [7.1% (21/297) vs 10.6% (34/320), p=0.16]. In patients with MSSA bloodstream infection (BSI), ICU LOS was 4.4 days shorter in the post-BCID2 period (7.8 vs 3.4 days, p< 0.001). Pharmacists successfully intervened to reduce vancomycin duration in 7.1% (21/297) and 16.3% (52/320) of patients in the pre- and post-BCID2 group, respectively (p< 0.001). Conclusion BCID2 implementation shortened the duration of vancomycin in patients with MSSA or CoNS bacteremia and facilitated pharmacist intervention to stop vancomycin in non-pathogenic CoNS positive blood cultures or switch to MSSA-targeted therapy in MSSA BSI. These data support BCID2 as a critical tool to improve appropriate antibiotic selection and shorten the time to safer and more effective treatment for patients with CoNS and MSSA bacteremia. Disclosures Joseph L. Kuti, PharmD, Abbvie: Advisor/Consultant|bioMerieux: Grant/Research Support|Merck: Grant/Research Support|Pfizer: Grant/Research Support|Shionogi Inc: Advisor/Consultant|Shionogi Inc: Grant/Research Support|Shionogi Inc: Honoraria|Venatorx: Grant/Research Support