No sites identified with IRB approval

The FDA-cleared Accelerate Pheno™ System and PhenoTest™ Blood Culture (BC) Kit will be used to assess the workflow impact of fast identification (ID)/ antimicrobial susceptibility testing (AST) in the microbiology lab and in the quality of care in patients with Gram-negative rod (GNR) bacteremia. Blood culture work up will be randomized to one of two arms: the positive blood culture will either undergo fast ID and AST using the Accelerate Pheno™ System and PhenoTest™ BC Kit or processing per the site's standard of care (SOC) procedures.

Inclusion Criteria:

• Adult (≥18 years of age) hospitalized patients with positive blood culture due to gram-negative rod (on Gram stain)
• Blood culture drawn in the Emergency Department (ED)

Exclusion Criteria:

• Patients not admitted to hospital
• Patients discharged from hospital prior to blood culture positivity
• Only the first positive blood culture for each patient of each hospitalization will be included during the study period; any subsequent episode of bloodstream infection (BSI) will be excluded
• Positive blood culture with GNR in the prior 7 days (if known at the time of randomization)
• Transferred from an outside hospital and had a history of a previously positive blood culture of the same organism in the prior 7 days (if known at the time of randomization)
• GNR plus gram-positive organism, gram-negative cocci, and/or yeast detected on blood culture Gram stain
• Deceased or palliative care at the time of randomization
• Patient who is moribund (does not survive the initial 72 hours after enrollment)