Evaluation of the QMAC-dRAST System Version 2.5 for Rapid Antimicrobial Susceptibility Testing of Gram-Negative Bacteria From Positive Blood Culture Broth and Subcultured Colony Isolates

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis Pub Date : 2024-05-28 DOI:10.1002/jcla.25043

Tae Yeul Kim, Minhee Kang, Hyang Jin Shim, On-Kyun Kang, Hee Jae Huh, Nam Yong Lee

{"title":"Evaluation of the QMAC-dRAST System Version 2.5 for Rapid Antimicrobial Susceptibility Testing of Gram-Negative Bacteria From Positive Blood Culture Broth and Subcultured Colony Isolates","authors":"Tae Yeul Kim, Minhee Kang, Hyang Jin Shim, On-Kyun Kang, Hee Jae Huh, Nam Yong Lee","doi":"10.1002/jcla.25043","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Rapid antimicrobial susceptibility testing (AST) for bloodstream infections (BSIs) facilitates the optimization of antimicrobial therapy, preventing antimicrobial resistance and improving patient outcomes. QMAC-dRAST (QuantaMatrix Inc., Korea) is a rapid AST platform based on microfluidic chip technology that performs AST directly using positive blood culture broth (PBCB). This study evaluated the performance of QMAC-dRAST for Gram-negative bacteria using PBCB and subcultured colony isolates, comparing it with that of VITEK 2 (bioMérieux, France) using broth microdilution (BMD) as the reference method.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We included 141 Gram-negative blood culture isolates from patients with BSI and 12 carbapenemase-producing clinical isolates of Enterobacterales spiked into blood culture bottles. QMAC-dRAST performance was evaluated using PBCB and colony isolates, whereas VITEK 2 and BMD were tested only on colony isolates.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>For PBCB, QMAC-dRAST achieved 92.1% categorical agreement (CA), 95.3% essential agreement (EA), with 1.8% very major errors (VMEs), 3.5% major errors (MEs), and 5.2% minor errors (mEs). With colony isolates, it exhibited 92.5% CA and 95.1% EA, with 2.0% VMEs, 3.2% MEs, and 4.8% mEs. VITEK 2 showed 94.1% CA and 96.0% EA, with 4.3% VMEs, 0.4% MEs, and 4.3% mEs. QMAC-dRAST yielded elevated error rates for specific antimicrobial agents, with high VMEs for carbapenems and aminoglycosides. The median time to result for QMAC-dRAST was 5.9 h for PBCB samples and 6.1 h for subcultured colony isolates.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The QMAC-dRAST system demonstrated considerable strengths and comparable performance to the VITEK 2 system; however, challenges were discerned with specific antimicrobial agents, underlining a necessity for improvement.</p>\n </section>\n </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"38 9","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11137843/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Laboratory Analysis","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jcla.25043","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Rapid antimicrobial susceptibility testing (AST) for bloodstream infections (BSIs) facilitates the optimization of antimicrobial therapy, preventing antimicrobial resistance and improving patient outcomes. QMAC-dRAST (QuantaMatrix Inc., Korea) is a rapid AST platform based on microfluidic chip technology that performs AST directly using positive blood culture broth (PBCB). This study evaluated the performance of QMAC-dRAST for Gram-negative bacteria using PBCB and subcultured colony isolates, comparing it with that of VITEK 2 (bioMérieux, France) using broth microdilution (BMD) as the reference method.

Methods

We included 141 Gram-negative blood culture isolates from patients with BSI and 12 carbapenemase-producing clinical isolates of Enterobacterales spiked into blood culture bottles. QMAC-dRAST performance was evaluated using PBCB and colony isolates, whereas VITEK 2 and BMD were tested only on colony isolates.

Results

For PBCB, QMAC-dRAST achieved 92.1% categorical agreement (CA), 95.3% essential agreement (EA), with 1.8% very major errors (VMEs), 3.5% major errors (MEs), and 5.2% minor errors (mEs). With colony isolates, it exhibited 92.5% CA and 95.1% EA, with 2.0% VMEs, 3.2% MEs, and 4.8% mEs. VITEK 2 showed 94.1% CA and 96.0% EA, with 4.3% VMEs, 0.4% MEs, and 4.3% mEs. QMAC-dRAST yielded elevated error rates for specific antimicrobial agents, with high VMEs for carbapenems and aminoglycosides. The median time to result for QMAC-dRAST was 5.9 h for PBCB samples and 6.1 h for subcultured colony isolates.

Conclusions

The QMAC-dRAST system demonstrated considerable strengths and comparable performance to the VITEK 2 system; however, challenges were discerned with specific antimicrobial agents, underlining a necessity for improvement.

Abstract Image

查看原文本刊更多论文

评估 QMAC-dRAST 系统 2.5 版对阳性血培养肉汤和菌落分离培养物中革兰氏阴性菌的快速抗菌药敏感性测试。

背景：针对血流感染（BSI）的快速抗菌药物药敏试验（AST）有助于优化抗菌药物治疗、预防抗菌药物耐药性并改善患者预后。QMAC-dRAST（韩国 QuantaMatrix 公司）是一种基于微流控芯片技术的快速 AST 平台，可直接使用阳性血培养肉汤（PBCB）进行 AST 检测。本研究评估了 QMAC-dRAST 使用 PBCB 和亚培养菌落分离物检测革兰氏阴性菌的性能，并将其与使用肉汤微稀释（BMD）作为参考方法的 VITEK 2（法国生物梅里埃公司）进行了比较：我们从 BSI 患者中采集了 141 份革兰氏阴性血培养分离物，并在血培养瓶中添加了 12 份产碳青霉烯酶的肠杆菌临床分离物。使用 PBCB 和菌落分离物对 QMAC-dRAST 的性能进行了评估，而 VITEK 2 和 BMD 仅对菌落分离物进行了测试：对于 PBCB，QMAC-dRAST 实现了 92.1% 的分类一致 (CA)、95.3% 的基本一致 (EA)、1.8% 的非常大误差 (VME)、3.5% 的大误差 (ME) 和 5.2% 的小误差 (mE)。对于菌落分离物，它显示出 92.5% 的 CA 和 95.1% 的 EA，其中 VME 占 2.0%，ME 占 3.2%，mE 占 4.8%。VITEK 2 的 CA 和 EA 分别为 94.1%和 96.0%，VMEs 为 4.3%，MEs 为 0.4%，mEs 为 4.3%。QMAC-dRAST 对特定抗菌药的错误率较高，碳青霉烯类和氨基糖苷类的 VME 较高。QMAC-dRAST检测PBCB样本的中位结果时间为5.9小时，亚培养菌落分离物的中位结果时间为6.1小时：结论：QMAC-dRAST 系统显示出相当大的优势，其性能可与 VITEK 2 系统媲美；但是，在特定抗菌剂方面存在挑战，因此有必要加以改进。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Clinical Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.