Same-Day Identification and Antimicrobial Susceptibility Testing of Bacteria in Positive Blood Culture Broths Using Short-Term Incubation on Solid Medium with the MicroFlex LT, Vitek-MS, and Vitek2 Systems
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Early and appropriate antibiotic treatment improves the clinical outcome of patients with septicemia; therefore, reducing the turn-around time for identification (ID) and antimicrobial susceptibility test (AST) results is essential. We established a method for rapid ID and AST using short-term incubation of positive blood culture broth samples on solid media, and evaluated its performance relative to that of the conventional method using two rapid ID systems and a rapid AST method. Methods: A total of 254 mono-microbial samples were included. Positive blood culture samples were incubated on blood agar plates for six hours and identified by the MicroFlex LT (Bruker Daltonics) and Vitek-MS (bioMeriéux) systems, followed by AST using the Vitek2 System (bioMeriéux). Results: The correct species-level ID rates were 82.3% (209/254) and 78.3% (199/254) for the MicroFlex LT and Vitek-MS platforms, respectively. For the 1,174 microorganism/ antimicrobial agent combinations tested, the rapid AST method showed total concordance of 97.8% (1,148/1,174) with the conventional method, with a very major error rate of 0.5%, major error rate of 0.7%, and minor error rate of 1.0%. Conclusions: Routine implementation of this short-term incubation method could provide ID results on the day of blood culture-positivity detection and one day earlier than the conventional AST method. This simple method will be very useful for rapid ID and AST of bacteria from positive blood culture bottles in routine clinical practice.
Abstract
Background: Early and appropriate antibiotic treatment improves the clinical outcome of patients with septicemia; therefore, reducing the turn-around time for identification (ID) and antimicrobial susceptibility test (AST) results is essential. We established a method for rapid ID and AST using short-term incubation of positive blood culture broth samples on solid media, and evaluated its performance relative to that of the conventional method using two rapid ID systems and a rapid AST method. Methods: A total of 254 mono-microbial samples were included. Positive blood culture samples were incubated on blood agar plates for six hours and identified by the MicroFlex LT (Bruker Daltonics) and Vitek-MS (bioMeriéux) systems, followed by AST using the Vitek2 System (bioMeriéux). Results: The correct species-level ID rates were 82.3% (209/254) and 78.3% (199/254) for the MicroFlex LT and Vitek-MS platforms, respectively. For the 1,174 microorganism/ antimicrobial agent combinations tested, the rapid AST method showed total concordance of 97.8% (1,148/1,174) with the conventional method, with a very major error rate of 0.5%, major error rate of 0.7%, and minor error rate of 1.0%. Conclusions: Routine implementation of this short-term incubation method could provide ID results on the day of blood culture-positivity detection and one day earlier than the conventional AST method. This simple method will be very useful for rapid ID and AST of bacteria from positive blood culture bottles in routine clinical practice.
참고문헌 (19)
- Paul M, "Systematic review and meta-analysis of the efficacy of appropriate empiric antibiotic therapy for sepsis", Antimicrob Agents Chemother, 54, pp.4851~4863 (2010)[DOI]
- Seng P, "MALDI-TOF-mass spectrometry applications in clinical microbiology", Future Microbiol, 5, pp.1733~1754 (2010)[DOI]
- Machen A, "Same day identification and full panel antimicrobial susceptibility testing of bacteria from positive blood culture bottles made possible by a combined lysis-filtration method with MALDI-TOF VITEK mass spectrometry and the VITEK2 system", PLoS One, 9, pp.e87870~ (2014)[DOI]
- Prod'hom G, "Matrix-assisted laser desorption ionization-time of flight mass spectrometry for direct bacterial identification from positive blood culture pellets", J Clin Microbiol, 48, pp.1481~1483 (2010)[DOI]
- Monteiro J, "Fast and reliable bacterial identification direct from positive blood culture using a new TFA sample preparation protocol and the <TEX>$Vitek^{(R)}$<", TEX> MS system, 2015, pp.109, 157~159
- Jakovljev A, "Development of a rapid and simplified protocol for direct bacterial identification from positive blood cultures by using matrix-assisted laser desorption ionization time-of- flight mass spectrometry", BMC Microbiol, 15, pp.258~ (2015)[DOI]
- 조성진, "Direct Identification and Antimicrobial Susceptibility Testing of Bacteria From Positive Blood Culture Bottles by Matrix-Assisted Laser Desorption", Ionization Time-of-Flight Mass Spectrometry and the Vitek 2 System, 2016, pp.36(2), 117~123[DOI]
- Chen JH, "Direct bacterial identification in positive blood cultures by use of two commercial matrix-assisted laser desorption ionization-time of flight mass spectrometry systems", J Clin Microbiol, 51, pp.1733~1739 (2013)[DOI]
- Buchan BW, "Comparison of the MALDI Biotyper system using Sepsityper sample processing to routine microbiological methods for identification of bacteria from positive blood culture bottles", J Clin Microbiol, 50, pp.346~352 (2012)[DOI]
- CLSI, "Performance standards for antimicrobial susceptibility testing. 24th ed. CLSI supplement M100-S24", Clinical and Laboratory Standards Institute, ~ (2014)
- Diekema DJ, "Epidemiology and outcome of nosocomial and community-onset bloodstream infection", J Clin Microbiol, 41, pp.3655~3660 (2003)[DOI]
- Huang AM, "Impact of rapid organism identification via matrix-assisted laser desorption", ionization time-of-flight combined with antimicrobial stewardship team intervention in adult patients with bacteremia and candidemia, 2013, pp.57, 1237~1245
- Vlek AL, "Direct matrix-assisted laser desorption ionization time-of-flight mass spectrometry improves appropriateness of antibiotic treatment of bacteremia", PLoS One, 7, pp.e32589~ (2012)[DOI]
- Kohlmann R, "MALDI-TOF mass spectrometry following short incubation on a solid medium is a valuable tool for rapid pathogen identification from positive blood cultures", Int J Med Microbiol, 305, pp.469~479 (2015)[DOI]
- Zabbe JB, "MALDI-TOF mass spectrometry for early identification of bacteria grown in blood culture bottles", J Microbiol Methods, 115, pp.45~46 (2015)[DOI]
- Hong SK, "Use of MALDI-TOF MS technique for rapid identification of bacteria from positive blood cultures", Indian J Med Microbiol, 32, pp.419~422 (2014)[DOI]
- Bhatti MM, "Rapid identification of positive blood cultures by matrix-assisted laser desorption ionizationtime of flight mass spectrometry using prewarmed agar plates", J Clin Microbiol, 52, pp.4334~4338 (2014)[DOI]
- Fan WT, "Performance of the matrix-assisted laser desorption ionization time-of-flight mass spectrometry system for rapid identification of streptococci: a review", Eur J Clin Microbiol Infect Dis, 36, pp.1005~1012 (2017)[DOI]
- "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems"[URL]
