Kikuchi Ken, Matsuda Mari, Iguchi Shigekazu, Mizutani Tomonori, Hiramatsu Keiichi, Tega-Ishii Michiru, Sansaka Kaori, Negishi Kenta, Shimada Kimie, Umemura Jun, Notake Shigeyuki, Yanagisawa Hideji, Takahashi Hiroshi, Yabusaki Reiko, Araoka Hideki, Yoneyama Akiko
Department of Infectious Diseases, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan; Sakakibara Heart Institute, 1-16-1 Asahimachi, Fuchu, Tokyo 183-0003, Japan; Department of Infection Control Science, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Department of Infection Control Science, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Can J Infect Dis Med Microbiol. 2017;2017:4896791. doi: 10.1155/2017/4896791. Epub 2017 Feb 20.
Early detection of Gram-positive bacteremia and timely appropriate antimicrobial therapy are required for decreasing patient mortality. The purpose of our study was to evaluate the performance of the Verigene Gram-positive blood culture assay (BC-GP) in two special healthcare settings and determine the potential impact of rapid blood culture testing for Gram-positive bacteremia within the Japanese healthcare delivery system. Furthermore, the study included simulated blood cultures, which included a library of well-characterized methicillin-resistant (MRSA) and vancomycin-resistant enterococci (VRE) isolates reflecting different geographical regions in Japan. A total 347 BC-GP assays were performed on clinical and simulated blood cultures. BC-GP results were compared to results obtained by reference methods for genus/species identification and detection of resistance genes using molecular and MALDI-TOF MS methodologies. For identification and detection of resistance genes at two clinical sites and simulated blood cultures, overall concordance of BC-GP with reference methods was 327/347 (94%). The time for identification and antimicrobial resistance detection by BC-GP was significantly shorter compared to routine testing especially at the cardiology hospital, which does not offer clinical microbiology services on weekends and holidays. BC-GP generated accurate identification and detection of resistance markers compared with routine laboratory methods for Gram-positive organisms in specialized clinical settings providing more rapid results than current routine testing.
早期检测革兰氏阳性菌血症并及时进行适当的抗菌治疗对于降低患者死亡率至关重要。我们研究的目的是评估Verigene革兰氏阳性血培养检测（BC-GP）在两种特殊医疗环境中的性能，并确定快速血培养检测革兰氏阳性菌血症在日本医疗系统中的潜在影响。此外，该研究还包括模拟血培养，其中包括一个经过充分表征的耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素肠球菌（VRE）菌株库，反映了日本不同地理区域的情况。对临床和模拟血培养共进行了347次BC-GP检测。将BC-GP结果与通过参考方法获得的结果进行比较，参考方法使用分子和基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）方法进行属/种鉴定和耐药基因检测。在两个临床地点和模拟血培养中进行的鉴定和耐药基因检测中，BC-GP与参考方法的总体一致性为327/347（94%）。与常规检测相比，BC-GP进行鉴定和抗菌药物耐药性检测的时间明显更短，尤其是在心脏病医院，该医院在周末和节假日不提供临床微生物学服务。与专门临床环境中革兰氏阳性菌的常规实验室方法相比，BC-GP能够准确鉴定和检测耐药标志物，比当前常规检测提供更快的结果。
