Evaluation of the Accelerate Pheno\texttrademark system for rapid identification and antimicrobial susceptibility testing of Gram-negative bacteria in bloodstream infections

Autor: Laurent Desmurs, Waël Salka, Marine Ibranosyan, Christine Fuhrmann, Ghislaine Descours, François Vandenesch, Olivier Dauwalder, Thi Lam Thuy Hoang, Anne-Gaëlle Ranc, Maud Baume
Přispěvatelé: Département de Microbiologie Clinique [HCL Groupement Hospitalier Nord, Lyon], Hospices Civils de Lyon (HCL)-HCL Groupement Hospitalier Nord [Lyon], Pathogenèse des légionelles- Legionella pathogenesis (LegioPath), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Pathogénie des Staphylocoques – Staphylococcal Pathogenesis (StaPath), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Time Factors
Ceftazidime
Bacteremia
medicine.disease_cause
law.invention
0302 clinical medicine
Medical microbiology
law
polycyclic compounds
Medicine
Antimicrobial susceptibility testing
030212 general & internal medicine
Child
Aged
80 and over
Accelerate Pheno\texttrademark system
biology
General Medicine
Middle Aged
3. Good health
Anti-Bacterial Agents
Bacterial Typing Techniques
Infectious Diseases
Gram staining
Child
Preschool
Gram-negative bacteria
[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology
[SDV.IMM]Life Sciences [q-bio]/Immunology
medicine.drug
Microbiology (medical)
Enterobacteriales
Adult
medicine.medical_specialty
Adolescent
Cefepime
030106 microbiology
Microbial Sensitivity Tests
03 medical and health sciences
Young Adult
Internal medicine
Sepsis
Humans
Aged
business.industry
Pseudomonas aeruginosa
Infant
Newborn
Infant
biology.organism_classification
medicine.disease
[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
Spectrometry
Mass
Matrix-Assisted Laser Desorption-Ionization
Bloodstream infections
business
Gram-Negative Bacterial Infections
Zdroj: European Journal of Clinical Microbiology and Infectious Diseases
European Journal of Clinical Microbiology and Infectious Diseases, Springer Verlag, 2018, 37 (8), pp.1573-1583. ⟨10.1007/s10096-018-3287-6⟩
European Journal of Clinical Microbiology and Infectious Diseases, 2018, 37 (8), pp.1573-1583. ⟨10.1007/s10096-018-3287-6⟩
ISSN: 0934-9723
1435-4373
Popis: International audience; Identification and antimicrobial susceptibility testing (AST) are critical steps in the management of bloodstream infections. Our objective was to evaluate the performance of the Accelerate Pheno\texttrademark System, CE v1.2 software, for identification and AST of Gram-negative pathogens from positive blood culture bottles. A total of 104 bottles positive for Gram-negative bacteria collected from inpatients throughout our institution were randomly selected after Gram staining. The time-to-identification and AST results, and the raw AST results obtained by the Accelerate Pheno\texttrademark system and routine techniques (MALDI-TOF MS and VITEK\textregistered2, EUCAST guidelines) were compared. Any discrepant AST result was tested by microdilution. The Pheno\texttrademark significantly improved turn-around times for identification (5.3 versus 23.7~h; p \textless 0.0001) and AST (10.7 versus 35.1~h; p \textless 0.0001). Complete agreement between the Accelerate Pheno\texttrademark system and the MALDI-TOF MS for identification was observed for 96.2% of samples; it was 99% (98/99) for monomicrobial samples versus 40% (3/5) for polymicrobial ones. The overall categorical agreement for AST was 93.7%; it was notably decreased for beta-lactams (cefepime 84.4%, piperacillin-tazobactam 86.5%, ceftazidime 87.6%) or Pseudomonas aeruginosa (71.9%; with cefepime 33.3%, piperacillin-tazobactam 77.8%, ceftazidime 0%). Analysis of discrepant results found impaired performance of the Accelerate Pheno\texttrademark system for beta-lactams (except cefepime) in Enterobacteriales (six very major errors) and poor performance in P. aeruginosa. The Accelerate Pheno\texttrademark system significantly improved the turn-around times for bloodstream infection diagnosis. Nonetheless, improvements in the analysis of polymicrobial samples and in AST algorithms, notably beta-lactam testing in both P. aeruginosa and Enterobacteriales, are required for implementation in routine workflow.
Databáze: OpenAIRE
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