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PNA FISH Improves Antibiotic Stewardship

 Our laboratory partnered with pharmacy to create an antibiotic stewardship program in 2003. Laboratory began sending culture and sensitivity reports to pharmacy twice a day. A pharmacist called the attending physician and recommended antibiotic therapy modifications. This program expedited appropriate antibiotic therapy by approximately 18 hours.   PNA FISH from AdvanDx was introduced in January 2009. S. aureus/CNS PNA FISH allowed microbiologists to rapidly differentiate Stapylococcus aureus from coagulase- negative staphylococci. E. faecalis/OE PNA FISH was introduced in July 2009 and GNR Traffic Light PNA FISH in April 2010. These kits allowed us to identify 63% of all blood cultures on the same day that they turned positive. The average time for bacterial identification decreased from 132 to 38 hours. By immediately sending this information to pharmacy, the average antibiotic dose per patient decreased from 5.8 to 2.8 and the average cost for laboratory tests and antibiotics decreased from $72 to $18 per patient. The addition of PNA FISH greatly enhanced antibiotic stewardship within the health system. This is a perfect example of how laboratory and pharmacy can work together to improve patient care and decrease downstream health care costs.   More detailed information about this technology is available in the article entitled, “Peptide Nucleic Acid FISH for Blood Culture Identification”, located in the Test Interpretation section. Also see,

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