Rapid and cost-effective identification and antimicrobial susceptibility testing in patients with Gram-negative bacteremia directly from blood-culture fluid
Autor: | Micol Piperno, Anna Altieri, Cartesio Favalli, Camilla Dolfa, Silvia Minelli, Maria Cristina Bossa, Christina Sakarikou |
---|---|
Rok vydání: | 2018 |
Předmět: |
0301 basic medicine
Microbiology (medical) Bacteremia Direct identification Rapid susceptibility profile medicine.medical_specialty Time Factors Gram-negative bacteria bacteremia direct identification rapid susceptibility profile anti-bacterial agents bacterial typing techniques bacteriological techniques blood culture diagnostic tests routine gram-negative bacteria humans microbial sensitivity tests sepsis spectrometry mass matrix-assisted laser desorption-ionization time factors cost-benefit analysis Cost-Benefit Analysis 030106 microbiology Antimicrobial susceptibility Microbial Sensitivity Tests Microbiology Sepsis 03 medical and health sciences Internal medicine Gram-Negative Bacteria medicine Humans Antimicrobial stewardship Blood culture In patient Molecular Biology Bacteriological Techniques medicine.diagnostic_test biology Diagnostic Tests Routine business.industry Settore MED/07 - Microbiologia e Microbiologia Clinica Antimicrobial medicine.disease biology.organism_classification Anti-Bacterial Agents Bacterial Typing Techniques Blood Culture Spectrometry Mass Matrix-Assisted Laser Desorption-Ionization business |
Zdroj: | Journal of Microbiological Methods. 146:7-12 |
ISSN: | 0167-7012 |
DOI: | 10.1016/j.mimet.2018.01.012 |
Popis: | Rapid pathogen identification (ID) and antimicrobial susceptibility testing (AST) in bacteremia cases or sepsis could improve patient prognosis. Thus, it is important to provide timely reports, which make it possible for clinicians to set up appropriate antibiotic therapy during the early stages of bloodstream infection (BSI). This study evaluates an in-house microbiological protocol for early ID as well as AST on Gram negative bacteria directly from positive monomicrobial and polymicrobial blood cultures (BCs). A total of 102 non-duplicated positive BCs from patients with Gram-negative bacteremia were tested. Both IDs and ASTs were performed from bacterial pellets extracted directly from BCs using our protocol, which was applied through the combined use of a MALDI-TOF MS and Vitek2 automated system. The results of our study showed a 100% agreement in bacterial ID and 98.25% categorical agreement in AST when compared to those obtained by routine conventional methods. We recorded only a 0.76% minor error (mE), 0.76% major error (ME) and a 0.20% very major error (VME). Moreover, the turnaround time (TAT) regarding the final AST report was significantly shortened (ΔTAT = 8–20 h, p This in-house protocol is rapid, easy to perform and cost effective and could be successfully introduced into any clinical microbiology laboratory. A final same-day report of ID and AST improves patient management, by early and appropriate antimicrobial treatment and could potentially optimize antimicrobial stewardship programs. |
Databáze: | OpenAIRE |
Externí odkaz: |
Pro tento záznam nejsou dostupné žádné jednotky.