Antimicrobial Stewardship and Rapid Diagnostic Testing in Bloodstream Infections
Summary
Bloodstream infections (BSIs) remain a leading cause of morbidity and mortality worldwide, demanding prompt and precise antimicrobial therapy. Antimicrobial stewardship seeks to optimise the use of antibiotics by integrating rapid diagnostic testing (RDT) technologies into clinical workflows. These advances enable clinicians to identify causative pathogens and their resistance profiles within hours rather than days, facilitating earlier de-escalation of broad-spectrum agents, reduction of adverse effects and restraint of antimicrobial resistance. Key innovations include molecular assays for direct detection of pathogen DNA and resistance genes, phenotypic systems that deliver growth-based susceptibility results in real time, and mass spectrometry methods for swift species identification. When embedded within multidisciplinary stewardship teams, these technologies support data-driven prescribing, shorter hospital stays and improved patient outcomes, underscoring their global significance in preserving antimicrobial efficacy.
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Antimicrobial Stewardship and Rapid Diagnostic Testing in Bloodstream Infections publication trend
The graph below shows the total number of articles in antimicrobial stewardship and rapid diagnostic testing in bloodstream infections across all publications each year (not limited to Nature Index journals).
Technical terms
Antimicrobial stewardship: Coordinated interventions to optimise the selection, dosage and duration of antimicrobial therapy.
Rapid diagnostic testing (RDT): Methods that accelerate pathogen identification and susceptibility determination to inform timely clinical decisions.
Phenotypic susceptibility testing: Culture-based techniques that assess microbial growth inhibition in the presence of antibiotics.
Genotypic susceptibility testing: Molecular assays that detect genetic markers of antimicrobial resistance.
Minimum inhibitory concentration (MIC): Lowest antimicrobial concentration that visibly inhibits microbial growth under defined conditions.
Matrix-Assisted Laser Desorption Ionisation Time-of-Flight (MALDI-TOF) MS: Mass spectrometry method for rapid identification of microorganisms directly from culture material.
References
- Rapid Phenotypic and Genotypic Antimicrobial Susceptibility Testing Approaches for Use in the Clinical Laboratory. Antibiotics (2024).
- Usefulness of BioFire FilmArray BCID2 for Blood Culture Processing in Clinical Practice. Journal of Clinical Microbiology (2021).
- Performance of the Reveal Rapid Antibiotic Susceptibility Testing System on Gram-Negative Blood Cultures at a Large Urban Hospital. Journal of Clinical Microbiology (2022).
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