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Performance evaluation of Alfred60AST rapid susceptibility testing directly from positive blood cultures in the routine laboratory workflow

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Abstract

The aim of this study was to evaluate the performance of the new automated system Alfred60AST which is based on light scattering technology for rapid susceptibility testing directly from positive blood cultures as well as its applicability in the routine laboratory workflow. We evaluated 176 significant episodes of bacteremia due to 92 Gram-negative and 84 Gram-positive bacteria. The antimicrobial agents tested were ceftriaxone, ciprofloxacin, gentamicin, meropenem, piperacillin-tazobactam, and colistin for Gram negatives and cefoxitin, vancomycin, linezolid, and daptomycin for Gram positives. Concordance assessment was performed in comparison with our routine method, Vitek2 (bioMérieux). Discrepancies were resolved with MICRONAUT-S (Merlin) or E-test (bioMérieux). Out of 690 susceptibility determinations, 94.05% showed categorical agreement (CA) with the routine method and this percentage increased to 94.49 after discrepancy analysis. There were 1.45% very major errors, 3.33% major errors, and 1.16% minor errors (decreased to 1.45, 3.04, and 1.01 after discrepancy analysis). The CA for most of the antibiotics was above 90% except for daptomycin for Gram positives (87.30%) and ceftriaxone for Gram negatives (88.23%). The concordance was slightly better for Gram negative than for Gram-positive bacteria (94.30 versus 93.70%, respectively). The total turnaround time for a complete Alfred60AST result was 6–6.5h. The evaluated method gave rapid and reliable results in a few hours, versus 48h for the conventional one. Implementing this technology in routine workflow allows clinicians to optimize the treatment on the same day of blood culture positivity with potential positive clinical benefits and impact on antibiotic stewardship.

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Acknowledgements

Part of the study was presented at the 30th ECCMID Abstract Book 2020.

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The datasets generated or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Microbiology, AHEPA University Hospital, S. Kiriakidi str. 1, 54636, Thessaloniki, Greece

    Paraskevi Mantzana, Fotini Netsika, Maria Arhonti, Georgios Meletis, Eleni Kandilioti, Maria Kiriakopoulou, Georgia Kagkalou, Olga Vasilaki, Areti Tychala, Efthymia Protonotariou & Lemonia Skoura

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  1. Paraskevi Mantzana
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  2. Fotini Netsika
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  3. Maria Arhonti
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  4. Georgios Meletis
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  5. Eleni Kandilioti
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  6. Maria Kiriakopoulou
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  7. Georgia Kagkalou
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  11. Lemonia Skoura
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Contributions

Conceptualization: Paraskevi Mantzana; methodology: Fotini Netsika, Maria Arhonti, Eleni Kandilioti, and Maria Kyriakopoulou; formal analysis and investigation: Georgios Meletis; writing - original draft preparation: Paraskevi Mantzana; writing - review and editing: Paraskevi Mantzana, Georgios Meletis, and Efthymia Protonotariou; comments on previous versions of the manuscript: Georgia Kagkalou, Olga Vasilaki, Areti Tychala, Efthymia Protonotariou, and Lemonia Skoura; supervision: Lemonia Skoura. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Paraskevi Mantzana.

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Ethics approval and consent to participate

Testing was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. No specific approval from our institutional ethics committee was required as testing was performed on residual samples and results were not used for patient’s therapeutic management.

No informed consent was needed for this study since samples were taken as part of the standard patient care and used anonymously.

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Not applicable.

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The authors declare no competing interests.

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Mantzana, P., Netsika, F., Arhonti, M. et al. Performance evaluation of Alfred60AST rapid susceptibility testing directly from positive blood cultures in the routine laboratory workflow. Eur J Clin Microbiol Infect Dis 40, 1487–1494 (2021). https://doi.org/10.1007/s10096-021-04191-9

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  • DOI: https://doi.org/10.1007/s10096-021-04191-9

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