Prospective evaluation of rapid antimicrobial susceptibility testing by disk diffusion on Mueller-Hinton rapid-SIR directly on blood cultures - PubMed (original) (raw)

Prospective evaluation of rapid antimicrobial susceptibility testing by disk diffusion on Mueller-Hinton rapid-SIR directly on blood cultures

Claire Périllaud et al. Diagn Microbiol Infect Dis. 2019 Jan.

Abstract

Background: With the worldwide spread of antibiotic resistance, delivering antibiotic susceptibility test (AST) results in a timely manner represents a major challenge. In cases of sepsis, rapid AST may facilitate early optimization of empiric antibiotic therapy. Disc diffusion is a well-standardized AST method, however 16 to 24 h are required to achieve an overall AST profile according to antimicrobial societies.

Methods: In this prospective pilot study, we evaluated the performance of Mueller-Hinton-Rapid-SIR (MHR-SIR) agar after 6-8 h of incubation in comparison with standard MH agar after 16 h of incubation directly on positive blood cultures caused by Enterobacteriaceae and Staphylococcus aureus from routine clinical microbiology. A total of 133 positive blood samples including 110 Enterobacteriaceae (83%) and 23 Staphylococcus aureus (17%) were tested in parallel by two direct AST methods, each using EUCAST breakpoints. For each combination bacterium and antibiotic, we compared the categorical agreement and the correlation between the diameters obtained by MHR-SIR and by standard MH.

Results: Our results showed 97.7% categorical agreement for Enterobacteriaceae, with 1.4% minor errors, 0.4% major errors and 0.5% very major errors. For S. aureus, we observed 97.8% categorical agreement, 1.9% minor errors, 0.3% major errors and no very major errors.

Conclusion: Our results showed excellent categorical agreement and correlations between diameters for MHR-SIR and standard MH methods. MHRSIR can predict the result of overall AST profile within 6-8 h with reliable results. AST is obtained on the same day the blood culture becomes positive, with a very moderate cost.

Keywords: Blood cultures; Disk diffusion; Mueller-Hinton rapid-SIR; Rapid antimicrobial susceptibility test.

PubMed Disclaimer

Cited by

EUCAST rapid antimicrobial susceptibility testing (RAST) in blood cultures: validation in 55 European laboratories.
Åkerlund A, Jonasson E, Matuschek E, Serrander L, Sundqvist M, Kahlmeter G; RAST Study Group. Åkerlund A, et al. J Antimicrob Chemother. 2020 Nov 1;75(11):3230-3238. doi: 10.1093/jac/dkaa333. J Antimicrob Chemother. 2020. PMID: 32789506 Free PMC article.
Rapid Detection of Methicillin-Resistant Staphylococcus aureus Directly from Blood for the Diagnosis of Bloodstream Infections: A Mini-Review.
Buonomini AR, Riva E, Di Bonaventura G, Gherardi G. Buonomini AR, et al. Diagnostics (Basel). 2020 Oct 15;10(10):830. doi: 10.3390/diagnostics10100830. Diagnostics (Basel). 2020. PMID: 33076535 Free PMC article. Review.
The EUCAST rapid disc diffusion method for antimicrobial susceptibility testing directly from positive blood culture bottles.
Jonasson E, Matuschek E, Kahlmeter G. Jonasson E, et al. J Antimicrob Chemother. 2020 Apr 1;75(4):968-978. doi: 10.1093/jac/dkz548. J Antimicrob Chemother. 2020. PMID: 32016342 Free PMC article.
Impact of Rapid Antimicrobial Susceptibility Testing in Gram-Negative Rod Bacteremia: a Quasi-experimental Study.
Hogan CA, Ebunji B, Watz N, Kapphahn K, Rigdon J, Mui E, Meng L, Alegria W, Holubar M, Deresinski S, Banaei N. Hogan CA, et al. J Clin Microbiol. 2020 Aug 24;58(9):e00360-20. doi: 10.1128/JCM.00360-20. Print 2020 Aug 24. J Clin Microbiol. 2020. PMID: 32434782 Free PMC article.

Prospective evaluation of rapid antimicrobial susceptibility testing by disk diffusion on Mueller-Hinton rapid-SIR directly on blood cultures - PubMed (original) (raw)