Clinical Tools

MDRA (Multi-Disease Risk Assessment) For Fungi

• A computerized algorithm that uses 34 pre-selected, weighted clinical and laboratory values (5,3,1) to implement laboratory procedures for detecting Fungemia based on Pfizer’s software.
• Multi-Disease Risk Assessment (MDRA) Fungal Infection Action Form
  [ Excel Version | PDF Version ]
  
  

Pharmaco-Economics Form: Linking X, Y, and Z

• A check sheet based on selected MICs that integrates pharmaco-kinetics (X), pharmaco-dynamics (Y) and pharmaco-economics (Z) for anti-infective comparison based on E-Test (AB Biodisc)
• Pharmacoeconomics Form [ PDF Version ]
  
  

Blood Culture Signature

• Distribution of frequent Bloodstream Isolates by Time to Detection, segregated by 6-Hospital Service Areas (corresponding to 6 Antibiograms), which allows for comparison of 50%, 75%, and 90% detection time or time organism will not be recovered. [ Click Here ]
  
  

MBEC (Minimal Biofilm Eradication Concentration)

• Method utilizing Calgary Biofilm Device (CBD) to determine effective inhibition of biofilms, mono or multiple species aerobic or anaerobic.  These clinical profiles with predetermined anti-infective dilutions are established for organisms associated with 3 symptoms: respiratory, urinary, and sepsis.  Also includes an Anti-Fungal MBEC and Dental MBEC using hydroxyapatite to duplicate the tooth enamel surface. The Ratio of MBEC:MIC, may be a clinical indicator or outcomes. [ Click Here ]
  
  
• Abstracts: Sessa, A., Myers, A., Schwegler-Berry, D. and Thomas, J. “Antibiofilm Effect of Oral Rinses on an Engineered Tooth Model.”  IADR Orlando 2006.
  
  Thomas, J.G., Sokos, L.G., Canfield, P., and Gray, D.  “Linking Adverse Outcome of Fungemic Patient to Organism Resistant Phenotype: BEC50 : MIC.  ASM Orlando 2006
  
  

Selected Antibiograms

• Antibiograms for WVUH isolates including bacterial and fungal www.wvuhlab.com
• Unique selection of antibiotic profiles, sorted by 1) mechanism of resistance, 2) relative resistance, and 3) clinical diseases: respiratory, wound, and indwelling medical devices (IMDs).  Uses the TSN USA electronic database with daily data contributions by >400 hospitals (www.mrlworld.com).
  [ Blood ] [ Urine ] [ All Specimens for All Locations ]
  
  

Bug-Drug Calculator

• Patented program to match WVUH isolates, by service and source, and stratify by sensitivity and cost, at time of physician order entry.
• Computerized Antimicrobial Decision Support: An Offline Evaluation of a Database-Driven Empiric Antimicrobial Guidance Program in Hospitalized Patients with a Bloodstream Infection. CJ Mullett, JG Thomas, et al. Int J Med Inf 2004 Jun 15:73(5):455-460.
• Database-Driven Computerized Antibiotic Decision Support: Novel use of Expert Antibiotic Susceptibility Rules Embedded in a Pathogen-Antibiotic Logic Matrix. CJ Mullett and JG Thomas. Proc AMIA Symp. 2003:480-483.
  
  

Mountain State Oral-Facial Microbiology Laboratory

• The importance of oral infections is emerging, given the concern about links with 3 systemic diseases: heart, lung, and adverse pregnancy outcomes.
• The Oral Facial Microbiology Laboratory is situated within the WVUH diagnostic laboratory in Ruby Memorial Hospital, combining strengths of both sections into one unique diagnostic unit (www.wvuhlab.com).
• The laboratory results are reviewed weekly by TEAM BIOFILM, a composite of Periodontists, Pharmacists, and Clinical Microbiologists, utilizing a unique report form. This includes the use of the Dental Antibiogram
  (www.wvuhlab.com)