“Rapid diagnosis of bloodstream infections; from Theory to clinical practice”

More people are dying from blood stream infections than from any other infectious disease. Therefore, it is important to start antibiotic therapy as soon as possible. Antibiotic therapy is often started without the pathogen being known. The current techniques take at least forty-eight hours to show whether the right antibiotic is being given. This dissertation describes two new reliable tests which identify the pathogen and show its sensitivity to the antibiotic sixteen hours sooner. It was shown that patients could indeed be administered the right antibiotic sooner, when these rapid techniques were being used. However, only in a limited number of patients the use of this rapid test actually resulted in treatment changes, which limited the effect of the technique on the use of antibiotics and the outcome for the patient. In order to create an optimal antibiotic treatment policy, it is shown that it is not only important to develop rapid tests, but also to focus more on the implementation in daily practice.

Key words: blood stream infections, rapid diagnosis, antibiotics, implementation