Impact of molecular rapid diagnostic testing on clinical outcomes in bloodstream infections: a meta-analysis

Molecular rapid diagnostic testing is considered superior to conventional microbiological methods for bloodstream infections. Molecular rapid diagnostic testing reduces time to organism identification, facilitates timely initiation of appropriate antimicrobial therapy, and improves clinical outcomes, including reduced mortality. The purpose of the study was to evaluate the impact of molecular rapid diagnostic testing on the results outcomes of bloodstream infections. We studied meta-analysis data and used a dichotomous or continuous model with fixed or random effects to get odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CIs). 51 studies with a total of 14,675 subjects were selected for the study. Molecular rapid diagnostic testing was associated with significantly lower mortality (OR, 0.66; 95% CI, 0.60–0.74, p < 0.001), mortality with Gram-positive organisms (OR, 0.73; 95% CI, 0.59–0.90, p = 0.004), mortality with Gram-negative organisms (OR, 0.72; 95% CI, 0.60–0.87, p < 0.001), mortality with multiple organisms (OR, 0.62; 95% CI, 0.47–0.82, p < 0.001), length of hospital stay (MD, -3.79; 95% CI, -5.61- -1.97, p < 0.001), intensive care unit length of stay (MD, -2.05; 95% CI, -3.21- -0.88, p < 0.001), and cost (MD, -5.48; 95% CI, -9.41- -1.55, p < 0.001) compared to conventional methods in bloodstream infections. Molecular fast diagnostic testing for bloodstream infections significantly reduced mortality risk. Molecular fast diagnostic testing also reduced the time to successful therapy and the duration of hospitalization. Molecular fast diagnostic tests ought to be integrated into the standard of treatment for patients with bloodstream infections. However, more studies are required to validate this finding.