Effect of Implementing the Verigene Gram-Positive Blood Culture Nucleic Acid Test (BC-GP) on Stewardship Outcomes and Cost in Blood Stream Infections (BSI)

Background. The rapid identification of the etiology and the evaluation of the antimicrobial susceptibility of the bacteria causing bacteremia is of outmost relevance to set up an adequate treatment of sepsis. In this study we evaluated the microarray based method, Verigene Gram-positive blood cultures (BC-GP) nucleic acid test (Nanosphere Inc., Northbrook, IL, USA) for the identification of Gram positive pathogens from positive blood cultures. The panel BC-GP is capable to identify 13 germs and 3 genes associated with antimicrobial resistance. Materials and Methods. In this study a total of 100 positive, non replicated and monomicrobic blood cultures have been evaluated. For testing on the Verigene platform using the BC-GP assay, 350 L of blood culture media from a positive the blood culture bottle. Results. A total of 100 positive blood cultures were tested by the Verigene BC-GP assay: out of these a total of 100 Gram-positive cocci were identified. The most frequent bacteria identified included staphylococci, streptococci and enterococci. Among staphylococci, Staphylococcus aureus accounted for 25% (15/60), with 38% of S. epidermidis 37% (23/60) and 37% (22/60) other CoNS. All the S. aureus isolates were correctly identified by BC-GP whereas in 2/45 cases (4%) BC-GP misidentified CoNS. In the case of enterococci 7/10 were E. faecalis and 3 E. faecium, all of these were correctly identified. Conclusions. The overall agreement with the results obtained by standard procedure is quite elevated (88%) and as a consequence the BC-GP panel could be used as a rapid diagnostic tool to give a faster response in the case of bacteremia associated with sepsis.

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Multicenter evaluation of the Verigene Gram-negative blood culture nucleic acid test for rapid detection of bacteria and resistance determinants in positive blood cultures

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2015.08.004 ◽

2015 ◽

Vol 83 (4) ◽

pp. 344-348 ◽

Cited By ~ 10

Author(s):

Naoki Uno ◽

Hiromichi Suzuki ◽

Hiromi Yamakawa ◽

Maiko Yamada ◽

Yuji Yaguchi ◽

...

Keyword(s):

Nucleic Acid ◽

Blood Culture ◽

Rapid Detection ◽

Blood Cultures ◽

Negative Blood Culture ◽

Gram Negative ◽

Nucleic Acid Test ◽

Resistance Determinants ◽

Acid Test

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Incidence of secondary blood stream infections in Covid 19 (SARS-nCoV II.) patients

Indian Journal of Microbiology Research ◽

10.18231/j.ijmr.2021.025 ◽

2021 ◽

Vol 8 (2) ◽

pp. 128-131

Author(s):

Asmabanu Shaikh ◽

Rachana Patel ◽

Anant Marathe

Keyword(s):

Blood Culture ◽

Blood Stream ◽

Blood Cultures ◽

Automated System ◽

Empiric Antibiotic Therapy ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Blood Stream Infections ◽

Gram Negative ◽

Gram Positive Bacteria

The symptomatology and severity of covid-19 ranges widely depending on stage of infection. Most of the patients with mild to moderate disease can be managed without hospitalization. The patients with risk factors are likely to progress to severe disease. Patients developing secondary blood stream infections require longer hospital stay and are likely to develop fatal disease. The antibiotic selection is key to successful treatment of secondary BSI. This is cross-sectional study of 166 COVID 19 patients admitted to ICU of Parul Sevashram Hospital who developed sepsis like syndrome and were subjected to blood culture.Blood cultures were performed of all the patients developing sepsis like syndrome. IDSA guidelines were followed during blood collection for culture. Blood cultures were monitored on automated blood culture system. ID and susceptibility of all the isolates were performed on automated system (VITEK 2).A total of 1915 patients were reported RT-PCR positive for SARS nCoV2 during the period of 1st March2020 to 30 October 2020. 452 patients needed hospitalization based on their Oxygen saturation and co-morbidities. Out of 452, 166 patients developed sepsis like syndrome and were subjected to blood culture. The Blood culture positivity was 37/166 (22.28%). Gram positive bacteria were found in 48.64% while gram negative bacteria were 43.24%. The Enterococcus was the most common Gram positive bacterial isolates in patients. Candida was isolated in 2/37 positive blood cultures. Gram negative bacteria were isolated mostly amongst those patients who were on Ventilator. Most of the Gram positive bacteria were sensitive to Clindamycin, Linezolid, Vancomycin, Daptomycin and Teicoplanin.The incidence rate of BSI was high. Early secondary blood stream infections were mostly endogenous. Enterococcus was the most common amongst Gram positive bacteria. Gram negative secondary bacterial infections were more common with patients on ventilator. The susceptibility pattern would help in decision making of empiric antibiotic therapy. Interestingly as described by some authors earlier the relationship between SARS nCoV 2 and Enterococci needs to be studied further.

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PATHOGENS CAUSING BLOOD STREAM INFECTIONS

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.12.850 ◽

2015 ◽

Vol 22 (12) ◽

pp. 1617-1623

Author(s):

Muhammad Saeed ◽

Farhan Rasheed ◽

Fouzia Ashraf ◽

Shagufta Iram ◽

Shahida Hussain ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Cardiac Surgery ◽

Blood Culture ◽

Blood Stream ◽

Cross Sectional Study ◽

Blood Cultures ◽

Gram Positive ◽

Cross Sectional ◽

Blood Stream Infections ◽

Gram Negative

Blood stream infections (BSI) remain a major cause of debility and death aroundthe world. BSI accounts for 10-20% of all Nosocomial infections. Empirical antimicrobials arebased on the susceptibility pattern of the pathogens isolated in a specific institute from timeto time. We have conducted this study only on cardiac Patients over two & half years of studyduration. Study design: Cross sectional study. Settings: Microbiology Department, Allama IqbalMedical College/Jinnah Hospital, Lahore. Study Period: January 2013 to July 2015. Materials& Methods: A total of 5411 blood culture specimens were collected from cardiac patientsincluding patients admitted to cardiology ward, coronary care unit (CCU), pre-operative andpost-operative cardiac surgery patients. The bottles containing BHI broth were incubated andwere subcultured after 24 hours, 72 hours, 120 hours, and 168 hours on blood and MacConkeyagars. Isolates were further identified with the help of Gram staining, biochemical reactionsand rapid tests like catalase, oxidase, coagulase, Analytical Profile Index (API) 20E and API20NE. Antimicrobial susceptibility of the isolate was carried out on Mueller-Hinton agar byModified Kirby Bauer disc diffusion technique according to the isolate as per recommendationsof Clinical and Laboratory Standards Institute (CLSI) guidelines 2013. Results: Out of total 5411patients, 3958(73.14%) were male, 1453(26.85%) were females. Out of total 5411 Specimens,only 486 (8.98%) were positive for bacterial growth. Out of total 486 positive blood cultures,261 (53.71%) were Gram positive isolates and 225 (46.29%) were Gram negative isolates.Out 486 positive blood cultures, 96 (19.75%) were from cardiology ward, 67 (13.78%) werefrom CCU, 113 (23.25%) were from pre operative cardiac surgery ward, 210 (43.20%) werefrom post operative cardiac surgery ward. Among Gram positives, Staphylococcus Specieswere most common organism isolated from 246 (50.61%) blood culture specimens. AmongGram negatives, Pseudomonas aeruginosa and E.coli were predominant organisms, isolatedfrom 81(16.66%) and 72(14.81%) blood culture specimens respectively. Conclusion: GramPositive isolates were more common as compared to Gram negative isolates. Vancomycin andLinezolid were the most effective drugs among Gram positive isolates. Piperacillin-Tazobactamwas most potent antimicrobial against Pseudomonas aeruginosa. For coli forms Tigecyclinewas most effective drug.

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Rapid Testing Using the Verigene Gram-Negative Blood Culture Nucleic Acid Test in Combination with Antimicrobial Stewardship Intervention against Gram-Negative Bacteremia

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.04259-14 ◽

2014 ◽

Vol 59 (3) ◽

pp. 1588-1595 ◽

Cited By ~ 51

Author(s):

Jacqueline T. Bork ◽

Surbhi Leekha ◽

Emily L. Heil ◽

LiCheng Zhao ◽

Rilwan Badamas ◽

...

Keyword(s):

Nucleic Acid ◽

Blood Culture ◽

Antibiotic Therapy ◽

Antimicrobial Stewardship ◽

Clinical Isolates ◽

Molecular Diagnostic ◽

Negative Blood Culture ◽

Gram Negative ◽

Nucleic Acid Test ◽

Acid Test

ABSTRACTRapid identification of microorganisms and antimicrobial resistance is paramount for targeted treatment in serious bloodstream infections (BSI). The Verigene Gram-negative blood culture nucleic acid test (BC-GN) is a multiplex, automated molecular diagnostic test for identification of eight Gram-negative (GN) organisms and resistance markers from blood culture with a turnaround time of approximately 2 h. Clinical isolates from adult patients at the University Maryland Medical Center with GN bacteremia from 1 January 2012 to 30 June 2012 were included in this study. Blood culture bottles were spiked with clinical isolates, allowed to incubate, and processed by BC-GN. A diagnostic evaluation was performed. In addition, a theoretical evaluation of time to effective and optimal antibiotic was performed, comparing actual antibiotic administration times from chart review (“control”) to theoretical administration times based on BC-GN reporting and antimicrobial stewardship team (AST) review (“intervention”). For organisms detected by the assay, BC-GN correctly identified 95.6% (131/137), with a sensitivity of 97.1% (95% confidence interval [CI], 90.7 to 98.4%) and a specificity of 99.5% (95% CI, 98.8 to 99.8%). CTX-M and OXA resistance determinants were both detected. Allowing 12 h from Gram stain for antibiotic implementation, the intervention group had a significantly shorter duration to both effective (3.3 versus 7.0 h;P< 0.01) and optimal (23.5 versus 41.8 h;P< 0.01) antibiotic therapy. BC-GN with AST intervention can potentially decrease time to both effective and optimal antibiotic therapy in GN BSI.

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