Comparison of rapid antimicrobial susceptibility testing of flash positive blood culture bottles using disk diffusion and automated broth microdilution on VITEK 2 compact with standard methods: Clinical Laboratory Standards Institute (CLSI) protocol

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology Pub Date : 2025-02-25 DOI:10.1016/j.ijmmb.2025.100809

Prerna S. Salian , Dhruti Sheth , Anurag K. Bari , Aruna Poojary , Seema Rohra , Minipriyaa R

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引用次数: 0

Abstract

Background

Sepsis requires prompt diagnosis for effective management. Standard Antimicrobial Susceptibility Testing (AST) is time-consuming, highlighting the need for Rapid Antimicrobial Susceptibility Testing (RAST) to provide reports earlier.

Purpose

To compare the results of RAST and AST in order to determine the feasibility and reliability of RAST.

Materials and methods

A study at a tertiary care facility analyzed 95 positive blood culture isolates. RAST was performed by Disk Diffusion (DD) and VITEK 2 Compact Automated Broth Microdilution (BMD) from flagged positive broth. In contrast, AST was performed by DD and BMD from isolated colonies.

Results

Among 95 Gram-negative bacteria (GNB), E. coli (n = 40), and K. pneumoniae (n = 19) were most common. RAST vs AST DD for GNB showed 91 % Categorical agreement (CA) with an overall Very Major Error (VME) and Major Error (ME) rates of 0.7 % & 2.2 % and respectively. For GNB, RAST vs. AST BMD demonstrated a CA of 97 % and Essential Agreement (EA) of 97.7 %, with VME and ME rates of 1.7 % (excluding E.coli + Cefepime drug bug pairs) and 0.1 % respectively.

Conclusion

These findings suggest that RAST is a reliable antimicrobial susceptibility tool for GNB from direct Blood Culture broths. RAST can support early initiation of targeted antimicrobial therapy in patients with sepsis.

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在 VITEK 2 Compact 上使用碟片扩散法和自动肉汤微量稀释法对闪阳血培养瓶进行快速抗菌药物敏感性测试与标准方法的比较：临床实验室标准协会指南 (CLSI) 规程。

背景：脓毒症需要及时诊断才能有效治疗。标准抗微生物药物敏感性试验（AST）耗时，突出了快速抗微生物药物敏感性试验（RAST）尽早提供报告的必要性。目的：比较RAST和AST的结果，以确定RAST的可行性和可靠性。材料和方法：某三级医疗机构的一项研究分析了95株阳性血培养分离物。标记阳性肉汤采用磁盘扩散（DD）和VITEK 2 Compact自动肉汤微量稀释（BMD）进行RAST。相比之下，AST是通过分离菌落的DD和BMD进行的。结果：95株革兰氏阴性菌（GNB）中以大肠杆菌（40株）和肺炎克雷伯菌（19株）最为常见。GNB的RAST与AST DD显示91%的分类一致性（CA），总体非常严重错误（VME）和主要错误（ME）率分别为0.7%和2.2%。对于GNB， RAST与AST BMD的CA为97%，基本一致性（EA）为97.7%，VME和ME率分别为1.7%（不包括大肠杆菌+头孢吡肟药物虫对）和0.1%。结论：RAST是一种可靠的GNB药敏检测工具。RAST可以支持败血症患者早期启动靶向抗菌治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Medical Microbiology IMMUNOLOGY-

CiteScore

2.20

自引率

0.00%

发文量

154

审稿时长

73 days

期刊介绍： Manuscripts of high standard in the form of original research, multicentric studies, meta analysis, are accepted. Current reports can be submitted as brief communications. Case reports must include review of current literature, clinical details, outcome and follow up. Letters to the editor must be a comment on or pertain to a manuscript already published in the IJMM or in relation to preliminary communication of a larger study. Review articles, Special Articles or Guest Editorials are accepted on invitation.