Mizoguchi Miyuki, Matsumoto Yoshimi, Saito Ryoichi, Sato Tomoaki, Moriya Kyoji
Department of Infection Control and Prevention, The University of Tokyo Hospital, Tokyo, 113-8655, Japan; Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Institute of Scientific and Industrial Research, Osaka University, Osaka, Japan.
J Infect Chemother. 2020 Jun;26(6):554-562. doi: 10.1016/j.jiac.2020.01.014. Epub 2020 Feb 27.
Proper treatment of bloodstream infections requires rapid, early determination of appropriate antibiotic agents, emphasizing the need for more rapid drug susceptibility testing. The Drug Susceptibility Testing Microfluidic (DSTM) device represents a novel method in which a small amount of bacterial suspension is injected into the microchip-like device and cultured for 3 h. However, it remains unknown whether the DSTM method can directly determine antibiotic susceptibilities from positive blood cultures. Here, we developed a new approach to directly assess drug susceptibility, using the DSTM method for positive blood cultures. We compare the utility and accuracy of DSTM with those of conventional susceptibility testing methods. Fifty positive blood cultures identified as gram-negative bacilli were used herein. The outcomes of drug susceptibility and resistance assays for positive blood cultures were compared to those of conventional susceptibility testing methods to evaluate their utility and accuracy. Method agreement rates between DSTM and standard methods often exceed 90%, suggesting a high positive correlation with conventional methods. Furthermore, our results show that a combination of multiple drugs in the DSTM device helps identify extended-spectrum β-lactamase (ESBL)- and AmpC-β-lactamase (AmpC-)-producing microorganisms. In conclusion, DSTM method enables effective drug susceptibility and resistance screening within 3 h from positive blood cultures and is suitable for the rapid and personalized determination of the antimicrobial regimen.
血流感染的恰当治疗需要快速、早期确定合适的抗生素药物，这凸显了进行更快速药敏试验的必要性。药敏试验微流控（DSTM）装置代表了一种新方法，即将少量细菌悬液注入类似微芯片的装置中并培养3小时。然而，DSTM方法能否直接从阳性血培养物中确定抗生素敏感性仍不清楚。在此，我们开发了一种新方法，使用DSTM方法对阳性血培养物直接评估药敏性。我们将DSTM的实用性和准确性与传统药敏试验方法进行了比较。本文使用了50份鉴定为革兰氏阴性杆菌的阳性血培养物。将阳性血培养物的药敏和耐药试验结果与传统药敏试验方法的结果进行比较，以评估其实用性和准确性。DSTM与标准方法之间的方法一致率通常超过90%，表明与传统方法高度正相关。此外，我们的结果表明，在DSTM装置中联合使用多种药物有助于识别产超广谱β-内酰胺酶（ESBL）和AmpC-β-内酰胺酶（AmpC）的微生物。总之，DSTM方法能够在阳性血培养物培养3小时内有效进行药敏和耐药性筛查，适用于快速且个性化地确定抗菌治疗方案。
