Implementing EUCAST rapid antimicrobial susceptibility testing method for sepsis: lessons learned in a tertiary care center
| Autor: | Mohammad Aadam Bin Najeeb, Jogender Yadav, Farha Siddiqui, Ayush Gupta, Vishnu Teja Nallapati, Shashank Purwar |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Imipenem
medicine.medical_specialty Cefotaxime Klebsiella pneumoniae India Ceftazidime Microbiology Meropenem Tertiary Care Centers Sepsis Virology Internal medicine Gram-Negative Bacteria Tobramycin Humans Medicine Prospective Studies biology Diagnostic Tests Routine business.industry General Medicine biology.organism_classification Anti-Bacterial Agents Acinetobacter baumannii Infectious Diseases Blood Culture Parasitology Gentamicin Reagent Kits Diagnostic business medicine.drug |
| Zdroj: | The Journal of Infection in Developing Countries. 15:833-839 |
| ISSN: | 1972-2680 |
| Popis: | Introduction: We prospectively evaluated EUCAST rapid antimicrobial susceptibility testing methodology for susceptibility testing directly from blood culture bottles in comparison to CLSI disk-diffusion method. Methodology: During May-November 2019, positively flagged blood culture bottles showing Gram-negative micro-organisms were simultaneously processed by rapid antimicrobial susceptibility testing and CLSI methodology. Antibiotics tested were cefotaxime, ceftazidime, piperacillin-tazobactam, imipenem, meropenem, gentamicin, tobramycin and trimethoprim-sulphamethoxazole. Results: Overall, 80 isolates identified as Escherichia coli (n = 24, 30%), Klebsiella pneumoniae (n = 15, 18.7%), Pseudomonas aeruginosa (n = 16, 20%) and Acinetobacter baumannii (n = 25, 31.2%) were included. Categorical agreements of rapid antimicrobial susceptibility testing at 4-, 6- and 8-hour reading times were 88.1% (304/345), 90.8% (425/468) and 92.3% (467/506), respectively. Major Error rates were 14% (21/150), 4.9% (10/206) and 4/236 (1.7%), whereas Very Major Error rates were 1.1% (2/177), 1.3% (3/232) and 3.3% (8/243), respectively. Results categorized as “Area of Technical Uncertainty” were significantly lower at 8-hour {10.2% (39/384) vs 5.2% (28/534), 4- vs 8-hour, p = 0.003, Fischer’s exact test}. Conclusions: Except for a slightly higher Very major error rate, rapid antimicrobial susceptibility testing at 8-hour is equivalent to Disk-diffusion method (CLSI-M100) using CLSI-M52 criteria for equivalence: (Categorical agreement ≥ 90%, Very major error ≤ 1.5% and Major error ≤ 3%). Poor Categorical agreements at all reading times were noted for piperacillin-tazobactam, ciprofloxacin and E. coli. Performance of rapid antimicrobial susceptibility testing methodology in resource limited settings brings unique challenge of identifying micro-organisms within 8 hours. We suggest reading and reporting of results at a single time point using rapid antimicrobial susceptibility testing method i.e. at 8-hour. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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