Rapid identification and antimicrobial susceptibility testing of Gram-negative rod on positive blood cultures using Micr
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ORIGINAL ARTICLE
Rapid identification and antimicrobial susceptibility testing of Gram-negative rod on positive blood cultures using MicroScan panels A. Infante 1
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V. Ortiz de la Tabla 1
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C. Martín 1
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G. Gázquez 1
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F. Buñuel 1
Received: 13 May 2020 / Accepted: 24 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
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 thirdgeneration 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. Keywords Antimicrobial susceptibility testing . Directly from blood cultures . Gram-negative rods
Introduction Shortening the turnaround time of antimicrobial susceptibility testing (AST) of bacteria permits a significant reduction of patient morbidity, mortality, and cost [1, 2]. Rapid identification and AST reduce antibiotic use and accelerate pathogendirected antibiotic treatment [3]. Mainly for patients with septicemia, AST results are very important for appropriate treatment and clinical outcome [4]. Conventional blood culture methods are the gold standard diagnostic test to guide management of patients with sepsis, but the conventional process requires at least 12 to 24 h after
* A. Infante [email protected] 1
Servicio de Microbiología, Hospital Universitario San Juan de Alicante, Alicante, Spain
the blood culture has been flagged as positive to permit colonial growth from subcultures of positive culture bottles [5, 6]. Despite improvements offered by molecular biology and matrix-assisted laser desorption/ionizationtime- of-flight mass spectrometry (MALDI-TOF MS) in the rapid identification, the turnaround time
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