革兰氏阴性杆菌菌血症患者血培养直接采用 VITEK®2 快速进行抗菌药物敏感性检测。
Rapid antimicrobial susceptibility testing by VITEK®2 directly from blood cultures in patients with Gram-negative rod bacteremia.
机构信息
Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA; Clinical Microbiology Laboratory, Stanford University Medical Center, Palo Alto, CA, USA.
Clinical Microbiology Laboratory, Stanford University Medical Center, Palo Alto, CA, USA.
出版信息
Diagn Microbiol Infect Dis. 2019 Jun;94(2):116-121. doi: 10.1016/j.diagmicrobio.2019.01.001. Epub 2019 Jan 16.
OBJECTIVE
Optimizing therapy for bacteremia is currently limited by the 1-2-day turnaround time required for antimicrobial susceptibility testing (AST). Here, we assess a rapid AST method with VITEK®2 (bioMérieux, France) directly from positive blood cultures.
METHODS
Patient-derived positive blood cultures with Gram-negative rods identified as Enterobacteriaceae and Pseudomonas aeruginosa were prospectively tested, and other blood culture bottles were spiked with carbapenem-resistant Enterobacteriaceae (CRE). Positive cultures were subjected to red blood cell lysis and centrifugation, and setup on VITEK®2.
RESULTS
A total of 109 patient blood cultures and 52 spiked blood cultures were tested. Overall, essential agreement was 97.7% [95% confidence interval (CI) 96.4-99.0], and categorical agreement was 96.8% (95% CI 95.0-98.6). Mean turnaround time from setup to susceptibility results for Enterobacteriaceae in the clinical cultures was 9.0 (±1.3) h.
CONCLUSIONS
Direct susceptibility testing of blood cultures by VITEK®2 for Enterobacteriaceae is an accurate, practical, and inexpensive diagnostic strategy for rapid automated AST.
目的
目前，由于抗菌药物敏感性检测（AST）需要 1 到 2 天的周转时间，因此限制了对菌血症的治疗优化。在此，我们评估了一种从阳性血培养物直接进行的快速 AST 方法，即 VITEK®2（法国生物梅里埃公司）。
方法
前瞻性检测了革兰氏阴性杆菌阳性血培养物，这些杆菌被鉴定为肠杆菌科和铜绿假单胞菌，并且其他血培养瓶中也加入了耐碳青霉烯类肠杆菌科（CRE）。阳性培养物经过红细胞裂解和离心处理，然后在 VITEK®2 上进行设置。
结果
共检测了 109 份患者血培养物和 52 份加标血培养物。总体而言，基本符合率为 97.7%（95%置信区间 96.4-99.0），类别符合率为 96.8%（95%置信区间 95.0-98.6）。临床培养物中肠杆菌科的设置到药敏结果的平均周转时间为 9.0（±1.3）小时。
结论
VITEK®2 直接对血培养物进行肠杆菌科的药敏检测是一种准确、实用且经济的快速自动化 AST 诊断策略。
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