Comparison of Accelerate PhenoTest BC Kit and MALDI-TOF MS/VITEK 2 System for the rapid identification and antimicrobial susceptibility testing of gram-negative bacilli causing bloodstream infections

2020 ◽  
Vol 5 (3) ◽  
pp. 145-157
Author(s):  
William Stokes ◽  
Lorraine Campbell ◽  
Johann Pitout ◽  
John Conly ◽  
Deirdre Church ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Bloodstream Infections ◽  
Rapid Identification ◽  
Antimicrobial Susceptibility Testing ◽  
Gram Negative ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Vitek 2 ◽  
Tof Ms

scholarly journals Comparison of Accelerate PhenoTest™ BC Kit vs. MALDI-TOF MS/VITEK®2 System for the Rapid Identification and Antimicrobial Susceptibility Testing of Gram-negative Bacilli Causing Bloodstream Infections

2019 ◽  
Author(s):  
William Stokes ◽  
Lorraine Campbell ◽  
Johann Pitout ◽  
John Conly ◽  
Deirdre Church ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Bloodstream Infections ◽  
Antimicrobial Susceptibility Testing ◽  
Clinical Samples ◽  
Gram Negative ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Conventional Methods ◽  
Tof Ms

Abstract Introduction: Our laboratory uses MALDI-TOF MS (MALDI) and the VITEK®2 system (DV2) directly from positive blood cultures (BC) for organism identification (ID) and antimicrobial susceptibility testing (AST). Our objective was to compare direct MALDI/DV2 to a commercial BC ID/AST platform, the Accelerate Pheno™ system, in the ID/AST of clinical and seeded BC positive for Gram-negative bacilli (GNB). Methods: BC positive for GNB were collected over a three month period and tested using AXDX, direct MALDI/DV2, and compared to conventional methods. A subset of sterile BC were seeded with multi-drug resistant GNB. Discrepancies in very major errors (VME) and major errors (ME) were confirmed with broth microdilution. Results: A total of 29 clinical samples and 35 seeded samples were analyzed. Direct MALDI had a higher ID failure rate (31.0%) compared to AXDX (3.4%) [p<0.001]. Time to ID/AST was 1.5/6.9 hours, 5.8/16.5 hours and 21.6/33.0 hours for AXDX, direct MALDI/DV2 and conventional methods, respectively (p<0.001). For clinical samples, AXDX and DV2 had essential agreement (EA)/categorical agreement (CA) >96%. For seeded samples, AXDX had EA, CA, VME, ME and mE of 93.2%, 89.0%, 2.2%, 0%, and 9.2%, respectively. AXDX had a large number of non-reports (6.1%), stemming from meropenem testing. DV2 had EA, CA, VME, ME and mE of 97.5%, 94.7%, 1.3%, 0%, and 4.4%, respectively. Conclusions: AXDX had fewer ID failures and more rapid ID/AST results. Direct MALDI/DV2 and AXDX both had high agreement for clinical samples but direct MALDI/DV2 had higher agreement when challenged with MDR GNB.

scholarly journals A Prospective Evaluation of Two Rapid Phenotypical Antimicrobial Susceptibility Technologies for the Diagnostic Stewardship of Sepsis

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Cesira Giordano ◽  
Elena Piccoli ◽  
Veronica Brucculeri ◽  
Simona Barnini
Keyword(s):  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Rapid Identification ◽  
Blood Cultures ◽  
Gram Positive ◽  
Gram Negative ◽  
Maldi Tof Ms ◽  
Gram Positive Bacteria ◽  
Maldi Tof ◽  
Tof Ms

Rapid identification of bloodstream pathogens by MALDI-TOF MS and the recently introduced rapid antimicrobial susceptibility testing (rAST) directly from positive blood cultures allow clinicians to promptly achieve a targeted therapy, especially for multidrug resistant microorganisms. In the present study, we propose a comparison between phenotypical rASTs performed in light-scattering technology (Alfred 60AST, Alifax®) and fluorescencein situhybridization (Pheno™, Accelerate) directly from positive blood cultures, providing results in 4–7 hours. Blood samples from 67 patients admitted to the Azienda Ospedaliero-Universitaria Pisana were analyzed. After the direct MALDI-TOF MS identification, the rAST was performed at the same time both on Alfred 60AST and Pheno. Alfred 60AST provided qualitative results, interpreted in terms of clinical categories (SIR). Pheno provided identification and MIC values for each antibiotic tested. Results were compared to the broth microdilution assay (SensiTitre™, Thermo Fisher Scientific), according to EUCAST rules. Using Alfred 60AST, an agreement was reached, 91.1% for Gram-negative and 95.7% for Gram-positive bacteria, while using Pheno, the agreement was 90.6% for Gram-negative and 100% for Gram-positive bacteria. Both methods provided reliable results; Alfred 60AST combined with MALDI-TOF MS proved itself faster and cheaper. Pheno provided identification and MIC determination in a single test and, although more expensive, may be useful whenever MIC value is necessary and where MALDI-TOF MS is not present.

MALDI-TOF MS identification and antimicrobial susceptibility testing directly from positive enrichment broth

2017 ◽  
Vol 141 ◽  
pp. 32-34 ◽  
Author(s):  
Marie Tré-Hardy ◽  
Barbara Lambert ◽  
Noémie Despas ◽  
Florian Bressant ◽  
Clémentine Laurenzano ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antimicrobial Susceptibility Testing ◽  
Enrichment Broth ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Tof Ms
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