Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.
Lett Appl Microbiol. 2021 Jul;73(1):2-8. doi: 10.1111/lam.13481. Epub 2021 May 6.
Blood stream infections pose a major challenge for clinicians as the immediate application of an appropriate antibiotic treatment is the vital factor to safe the patients' lives. This preliminary study compares three different systems promising fast pathogen identification and susceptibility testing in comparison to conventional blood culture (BC): (i) the rapid antimicrobial susceptibility testing protocol according to EUCAST in combination with the Sepsityper kit (sRAST), (ii) the direct inoculation method on the VITEK 2 system (dVIT) and (iii) testing with the Accelerate Pheno system (AccPh). All methods were assessed in terms of accuracy, time to result and usability. Twenty-three BC samples obtained from patients suffering from proven sepsis were analysed in detail. Pathogen identification was successful in 95·6, 91·3 and 91·3% in sRAST, dVIT and AccPh, respectively. Categorical agreement in antimicrobial susceptibility testing was 89·5, 96 and 96·6%, respectively. Time to result from sample entry to reporting ranged from an average of 4·6 h for sRAST and 6·9 h for AccPh to 10·6 h for dVIT. These results imply a significant shortening of reporting times at considerably high agreement rates for these new diagnostic approaches.
血流感染对临床医生构成了重大挑战，因为立即应用适当的抗生素治疗是确保患者生命安全的关键因素。本初步研究比较了三种不同的系统，这些系统有望快速鉴定病原体并进行药敏试验，与传统的血培养（BC）相比：（i）根据 EUCAST 的快速抗菌药敏试验方案与 Sepsityper 试剂盒（sRAST）联合使用，（ii）直接在 VITEK 2 系统上接种（dVIT），（iii）使用 Accelerate Pheno 系统（AccPh）进行检测。所有方法均在准确性、结果报告时间和可用性方面进行了评估。详细分析了 23 份来自确诊败血症患者的 BC 样本。sRAST、dVIT 和 AccPh 分别成功鉴定出 95.6%、91.3%和 91.3%的病原体。在抗菌药物敏感性试验中，分类一致性分别为 89.5%、96%和 96.6%。从样本进入到报告的时间，sRAST 的平均时间为 4.6 小时，AccPh 为 6.9 小时，dVIT 为 10.6 小时。这些结果表明，这些新的诊断方法在显著缩短报告时间的同时，具有相当高的一致性。
