Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
J Clin Microbiol. 2021 Apr 20;59(5). doi: 10.1128/JCM.02637-20.
The Accelerate Pheno system is approved for rapid identification and phenotypic antimicrobial susceptibility testing (AST) of microorganisms grown from positive blood cultures inoculated with blood from septic patients. We evaluated the performance of the system for identification and AST from positive blood culture bottles inoculated with primary sterile nonblood specimens from patients with suspected severe infections. One hundred positive blood culture bottles with primary sterile specimens (63 cerebrospinal fluids, 16 ascites, 7 pleural fluids, 4 vitreous fluids, 5 joint aspirates, and 5 other aspirates) from 100 patients were included. Pathogen identification was in agreement with conventional methods for 72 of 100 cultures (72%) and for 81 of 112 (72%) pathogens when considering all pathogens and for 72 of 92 (78%) cultures and 81 of 104 (78%) pathogens when considering on-panel pathogens only. Eight of 31 isolates (26%) not identified by APS were pathogens not included in the APS panel. APS and conventional methods accordingly identified all pathogens from two of nine polymicrobial cultures (22%). APS generated antimicrobial resistance results for 57 pathogens of 57 cultures. The overall category agreement between APS and culture-based AST was 91.2%; and the rate for minor errors was 6.9%, for major was 1.7%, and for very major errors was 0.2%. APS may accelerate pathogen identification and phenotypic AST from positive blood culture bottles inoculated with primary sterile specimens from patients with serious infections, especially for hospitals without an on-site microbiology laboratory. However, the inclusion of nonblood specimens with a high likelihood of polymicrobial infections may result in an inferior performance.
Accelerate Pheno 系统被批准用于快速鉴定和表型抗菌药物敏感性测试（AST）从接种有败血症患者血液的阳性血培养物中生长的微生物。我们评估了该系统用于鉴定和 AST 从疑似严重感染患者的原发性无菌非血标本接种的阳性血培养瓶的性能。纳入了 100 例疑似严重感染患者的 100 个阳性血培养瓶的原发性无菌标本（63 例脑脊液、16 例腹水、7 例胸腔积液、4 例玻璃体、5 例关节抽吸液和 5 例其他抽吸液）。100 个培养物中有 72 个（72%）和 112 个病原体中的 81 个（72%）（考虑所有病原体）与传统方法一致，当仅考虑面板上的病原体时，92 个培养物中有 72 个（78%）和 104 个病原体中有 81 个（78%）与传统方法一致。31 个未被 APS 鉴定的分离物中有 8 个（26%）不是 APS 面板中包含的病原体。APS 和传统方法因此从 9 个混合培养物中的 2 个（22%）中鉴定出了所有病原体。APS 为 57 个培养物中的 57 个病原体生成了抗菌药物耐药性结果。APS 和基于培养的 AST 之间的总体类别一致性为 91.2%；次要错误率为 6.9%，主要错误率为 1.7%，非常大错误率为 0.2%。APS 可能会加速从接种有疑似严重感染患者的原发性无菌标本的阳性血培养瓶中鉴定病原体和表型 AST，尤其是对于没有现场微生物学实验室的医院。然而，包括极有可能发生混合感染的非血标本可能会导致性能下降。
