scholarly journals Effect of Antimicrobial Stewardship with Rapid MALDI-TOF Identification and Vitek 2 Antimicrobial Susceptibility Testing on Hospitalization Outcome

2019 ◽  
Author(s):  
Stephen J Cavalieri ◽  
Seunghyug Kwon ◽  
Renuga Vivekanandan ◽  
Sumaya Ased ◽  
Cassara Carroll ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Length Of Hospital Stay ◽  
Antimicrobial Susceptibility Testing ◽  
Maldi Tof ◽  
Motion Study ◽  
Appropriate Treatment ◽  
Appropriate Therapy ◽  
Vitek 2 ◽  
Organism Identification

AbstractIntroductionRapid organism identification (ID) and antimicrobial susceptibility testing (AST) along with antibiotic stewardship (ASP) are critical to appropriate treatment. We sought to capture time for bacterial culture and initiation of appropriate therapy for patients, from 2017 (without MALDI-TOF/Vitek 2 and ASP) and 2018 (with MALDI-TOF/Vitek 2 and ASP).MethodsEligible patients admitted to our hospital with a positive sputum, blood, or urine culture. Sequential patients were retrospectively obtained from March 1 to May 31, 2017. Seventy-seven patients from 2017 were compared to 77 patients from 2018. A time-in-motion study was performed to compare time to identification (ID), AST results, and ASP team intervention for the two periods. Data were entered into SPSS (ver 25) for analysis. Results are reported as mean (± SD) or percentage.ResultsTime to organism ID was significantly faster in 2018 (2018 24.9 ± 14.4, 2017 33.8 ± 17 h, p=0.001). Time to AST results was also significantly faster for patients in 2018 compared to 2017 (18.2 ± 14 compared to 28.5 ± 14.9 h, p<0.001). ASP team recommended significantly more adjustments to empiric antimicrobial therapy in 2018 (28% of 2018 vs. 2% in 2017, p< 0.001). Length of hospital stay was significantly shorter in 2018 compared to 2017 (2018 10.7 ± 11.1 days and 2017 15.5 ± 18.1 days, p=0.05).ConclusionsUse of MALDI-TOF/Vitek 2 leads to an average 21.5 h faster ID and AST results that can be acted upon by ASP for appropriate antimicrobial recommendations.

Occurrence of Non-Fermenting Gram-Negative Bacilli and Their In Vitro Susceptibility Pattern by Vitek 2 at a Tertiary Care Teaching Hospital – An Observational Study

2021 ◽  
Vol 8 (8) ◽  
pp. 429-434
Author(s):  
Atit Dineshchandra Shah ◽  
Urvashi Natubhai Limbachia ◽  
Bhavin K. Prajapati ◽  
Lata Patel ◽  
Dharati Tusharbhai Shah ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Multidrug Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Antimicrobial Susceptibility Testing ◽  
Clinical Samples ◽  
Gram Negative ◽  
Vitek 2

BACKGROUND Non fermenting gram-negative bacilli (NFGNB) are a group of heterogenous, aerobic and non-sporing saprophytic bacteria, found as commensals in humans and other animals primarily causing opportunistic healthcare-associated infections. They are innately resistant to many antibiotics and are known to acquire resistance by various mechanisms. They pose a particular difficulty for the healthcare community because multidrug resistance is common and increasing among them and a number of strains have now been identified that exhibit pan drug resistance. This study was conducted to isolate and identify various non-fermenter gram negative bacilli (NFGNB), to study their antibiotic sensitivity pattern and their clinical significance from various clinical samples. METHODS A study was undertaken from March 2019 to February 2020 to isolate NFGNB from various clinical samples received for culture and sensitivity in the department of microbiology in a tertiary care hospital, Ahmedabad. Non lactose fermenting colonies on MacConkey agar plates were further processed by Vitek 2 to identify them and to study their antimicrobial susceptibility testing (AST). RESULTS A total of 2010 NFGNB were isolated from various clinical samples and their AST was evaluated by Vitek 2. Pseudomonas aeruginosa (52.7 %) and Acinetobacter baumannii (36.5 %) were the most common NFGNB isolated. Carbapenem resistance was 93 % for Acinetobacter species and 61 % for Pseudomonas species. CONCLUSIONS Accurate and rapid identification and antimicrobial susceptibility testing of NFGNB help in early initiation of appropriate antimicrobial therapy and proper management of patients thereby help in reducing emergence of MDR strains of NFGNB, mortality and overall hospital stay. KEYWORDS NFGNB – Non-Fermenting Gram-Negative Bacilli, Multidrug Resistance, Pan Drug Resistance, Carbapenem Resistance

scholarly journals Performance of Vitek 2 for Antimicrobial Susceptibility Testing of Staphylococcus spp. and Enterococcus spp.

2013 ◽  
Vol 52 (2) ◽  
pp. 392-397 ◽  
Author(s):  
A. M. Bobenchik ◽  
J. A. Hindler ◽  
C. L. Giltner ◽  
S. Saeki ◽  
R. M. Humphries ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antimicrobial Susceptibility Testing ◽  
Enterococcus Spp ◽  
Vitek 2 ◽  
Staphylococcus Spp

scholarly journals Comparative performances of Vitek-2, Disk Diffusion, and Broth Microdilution for antimicrobial susceptibility testing of canine Staphylococcus pseudintermedius

2021 ◽  
Author(s):  
Elisa Rampacci ◽  
Michele Trotta ◽  
Caterina Fani ◽  
Serenella Silvestri ◽  
Valentina Stefanetti ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antimicrobial Susceptibility Testing ◽  
Disk Diffusion ◽  
Health Concern ◽  
Broth Microdilution ◽  
Major Error ◽  
Staphylococcus Pseudintermedius ◽  
Cutaneous Infections ◽  
Vitek 2

Staphylococcus pseudintermedius is the primary cause of canine cutaneous infections and sporadically isolated as pathogen from humans. Rapidly emerging antibiotic-resistant strains are creating serious health concern so that accurate and timely antimicrobial susceptibility testing (AST) is crucial for patient care. Here, the performances of AST methods Vitek-2, Disk Diffusion (DD) and Broth Microdilution (BMD) were compared for the determination of susceptibility of 79 S. pseudintermedius isolates from canine cutaneous infections and one from human pyoderma to oxacillin (OXA), amoxicillin/clavulanate (AMC), cephalothin (CEF), gentamicin (GEN), enrofloxacin (ENR), doxycycline (DOX), clindamycin (CLI), inducible clindamycin resistance (ICR), mupirocin (MUP) and trimethoprim-sulfamethoxazole (SXT). Overall, the agreement of DD and Vitek-2 using veterinary AST-GP80 card with reference BMD was ≥ 90%, suggesting reliable AST performances. While DD generated mainly minor errors and one major error for OXA, Vitek-2 produced one very major error for GEN and it failed in identifying one ICR-positive isolate. Moreover, five bacteria were diagnosed as ICR-positive by Vitek-2 but they showed a non-induction resistance phenotype by manual methods. All S. pseudintermedius were interpreted as susceptible or intermediately susceptible to DOX using CLSI breakpoints for human staphylococci that match the DOX concentration range included in AST-GP80. However, this could lead to inappropriate antimicrobial prescription for S. pseudintermedius infections in companion animals. Considering the clinical and epidemiological importance of S. pseudintermedius , we encourage updating action by the system manufacturer to address AST for this bacterium.

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