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Rapid identification and antimicrobial susceptibility testing of Gram-negative rod on positive blood cultures using MicroScan panels

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Abstract

Shortening the turnaround time of antimicrobial susceptibility testing (AST) of bacteria permits a significant reduction of patient morbidity, mortality, and cost. Conventional blood culture methods are the gold standard diagnostic test to guide management of patient with sepsis, but the conventional process requires at least 12 to 24 h after the blood culture has been flagged as positive due to requirement for pure colonies. We describe a simple and inexpensive method to obtain faster AST with MicroScan system (Beckman Coulter) directly from positive blood cultures. Conventional and direct identification and AST were performed simultaneously by both methods in 1070 blood cultures, and 9106 MICs were determinated. About 96.5% were correctly identified with the direct method. Overall, categorical agreement was 92.86%. We found 46 very major errors, but globally the results showed a good correlation with the standard method, particularly favorable for E. coli and K. pneumoniae, except amoxicillin-clavulanate and piperacillin-tazobactam. For P. mirabilis, betalactams antibiotics (except second- and third-generation cephalosporines) showed a good correlation, and also a good correlation was found for ciprofloxacine and gentamicine in P. aeruginosa and amoxicillin-clavulanate, ciprofloxacine, gentamicine, and cotrimoxazole in E. cloacae. This method has the main advantage of providing reliable results 1 day earlier, being a simple, fast, and cheap method for identification and antimicrobial susceptibility testing results from positive blood cultures.

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References

  1. Doern GV, Vautour R, Gaudet M, Levy B (1994) Clinical impact of rapid in vitro susceptibility testing and bacterial identification. J Clin Microbiol 32(7):1757–1762

    Article  CAS  Google Scholar 

  2. Barenfanger J, Drake C, Kacich G (1999) Clinical and financial benefits of rapid bacterial identification and antimicrobial susceptibility testing. J Clin Microbiol 37(5):1415–1418

    Article  CAS  Google Scholar 

  3. Kerremans JJ, Verboom P, Stijnen T, Hakkaart-van Roijen L, Goessens W, Verbrugh HA et al (2008) Rapid identification and antimicrobial susceptibility testing reduce antibiotic use and accelerate pathogen-directed antibiotic use. J Antimicrob Chemother 61(2):428–435. https://doi.org/10.1093/jac/dkm497

    Article  CAS  PubMed  Google Scholar 

  4. Trenholme GM, Kaplan RL, Karakusis PH, Stine T, Fuhrer J, Landau W et al (1989) Clinical impact of rapid identification and susceptibility testing of bacterial blood culture isolates. J Clin Microbiol 27(6):1342–1345

    Article  CAS  Google Scholar 

  5. Barman P, Sengupta S, Singh S (2010) Study of a novel method to assist in early reporting of sepsis from the microbiology laboratory. J Infect Dev Ctries 4(12):822–827

    Article  Google Scholar 

  6. Dubourg G, Raoult D, Fenollar F (2019) Emerging methodologies for pathogen identification in bloodstream infections: an update. Expert Rev Mol Diagn 19:161–173. https://doi.org/10.1080/14737159.2019.1568241

    Article  CAS  PubMed  Google Scholar 

  7. Doern CD (2018) The slow March toward rapid phenotypic antimicrobial susceptibility testing: are we there yet? J Clin Microbiol 56:e01999–e01917. https://doi.org/10.1128/JCM.01999-17

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hogan CA, Watz N, Budvytiene I, Banaei N (2019) Rapid antimicrobial susceptibility testing by VITEK®2 directly from blood cultures in patients with Gram-negative rod bacteremia. Diagn Microbiol Infect Dis 94(2):116–121. https://doi.org/10.1016/j.diagmicrobio.2019.01.001

    Article  CAS  PubMed  Google Scholar 

  9. Bruins MJ, Bloembergen P, Ruijs GJHM, Wolfhagen MJHM (2004) Identification and susceptibility testing of Enterobacteriaceae and Pseudomonas aeruginosa by direct inoculation from positive BACTEC blood culture bottles into Vitek 2. J Clin Microbiol 42(1):7–11. https://doi.org/10.1128/JCM.42.1.7-11.2004

    Article  PubMed  PubMed Central  Google Scholar 

  10. Quesada MD, Giménez M, Molinos S, Fernández G, Sánchez MD, Rivelo R et al (2010) Performance of VITEK-2 compact and overnight MicroScan panels for direct identification and susceptibility testing of Gram-negative bacilli from positive FAN BacT/ALERT blood culture bottles. Clin Microbiol Infect 16(2):137–140. https://doi.org/10.1111/j.1469-0691.2009.02907.x

    Article  CAS  PubMed  Google Scholar 

  11. Funke G, Funke-kissling P (2004) Use of the BD PHOENIX Automated Microbiology System for direct identification and susceptibility testing of gram-negative rods from positive blood cultures in a three-phase trial. J Clin Microbiol 42(4):1466–1470. https://doi.org/10.1128/jcm.42.4.1466-1470.2004

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Ling TK, Liu ZK, Cheng AF (2004) Evaluation of the VITEK 2 system for rapid direct identification and susceptibility testing of gram-negative bacilli from positive blood cultures. J Clin Microbiol 41(10):4705–4707. https://doi.org/10.1128/jcm.41.10.4705-4707.2003

    Article  Google Scholar 

  13. Chapin KC, Musgnug MC (2003) Direct susceptibility testing of positive blood cultures by using Sensititre broth microdilution plates. J Clin Microbiol 41(10):4751–4754. https://doi.org/10.1128/jcm.41.10.4751-4754.2003

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Waites KB, Brookings ES, Moser SA, Zimmer BL (1998) Direct susceptibility testing with positive BacT/Alert blood cultures by using MicroScan overnight and rapid panels. J Clin Microbiol 36(7):2052–2056. https://doi.org/10.1128/JCM.36.7.2052-2056.1998

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Sánchez Yebra W, Obelleiro Campos AX, del Gigia AL, Cabezas Fernández T, Sánchez Gómez J, de Lamo SC et al (2019) Preliminary readings of antimicrobial susceptibility panels: a simple, fast and inexpensive way to detect bacterial resistance and enhance antibiotic treatment of bloodstream infections. Diagn Microbiol Infect Dis 94(4):398–402. https://doi.org/10.1016/j.diagmicrobio.2019.03.001

    Article  PubMed  Google Scholar 

  16. Maelegheer K, Nulens E (2017)Same-day identification and antibiotic susceptibility testing on positive blood cultures: a simple and inexpensive procedure. Eur J Clin Microbiol Infect Dis 36(4):681–687. https://doi.org/10.1007/s10096-016-2849-8

    Article  CAS  PubMed  Google Scholar 

  17. Clark RB, Lewinski MA, Loeffelholz MJ, Tibbetts RJ (2009) Cumitech 31A. In: Sharp SE (ed) Verification and validation of procedures in the clinical microbiology laboratory. Coordinating. ASM Press, Washington, DC

  18. Idelevich EA, Becker K (2019) How to accelerate antimicrobial susceptibility testing. Clin Microbiol Infect 25:1347–1355. https://doi.org/10.1016/j.cmi.2019.04.025

    Article  CAS  PubMed  Google Scholar 

  19. Smith KP, Kirby JE (2018) The inoculum effect in the era of multidrug resistance: minor differences in inoculum have dramatic effect on MIC determination. Antimicrob Agents Chemother 62:e000433–e000418. https://doi.org/10.1128/AAC.00433-18

    Article  Google Scholar 

  20. Wellinghausen N, Pietzcker T, Poppert S, Belak S, Fieser N, Bartel M et al (2007) Evaluation of the Merlin MICRONAUT system for rapid direct susceptibility testing of gram-positive cocci and gram-negative bacilli from positive blood cultures. J Clin Microbiol 45(3):789–795

    Article  CAS  Google Scholar 

  21. Campion M, Scully G (2018) Antibiotic use in the intensive care unit: optimization and De-escalation. J Intensive Care Med 33(12):647–655. https://doi.org/10.1177/0885066618762747

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Servicio de Microbiología, Hospital Universitario San Juan de Alicante, Alicante, Spain

    A. Infante, V. Ortiz de la Tabla, C. Martín, G. Gázquez & F. Buñuel

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  1. A. Infante
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  2. V. Ortiz de la Tabla
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  3. C. Martín
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  4. G. Gázquez
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  5. F. Buñuel
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Correspondence to A. Infante.

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Infante, A., Ortiz de la Tabla, V., Martín, C. et al. Rapid identification and antimicrobial susceptibility testing of Gram-negative rod on positive blood cultures using MicroScan panels. Eur J Clin Microbiol Infect Dis 40, 151–157 (2021). https://doi.org/10.1007/s10096-020-04014-3

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  • DOI: https://doi.org/10.1007/s10096-020-04014-3

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