Obsah

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
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