Department of Clinical Pharmacy, The Hospitals of Providence Transmountain Campus, El Paso, Texas, USA.
Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
Infect Disord Drug Targets. 2022;22(5):e100122200121. doi: 10.2174/1871526522666220110155719.
Rapid administration of appropriately indicated antibiotics is crucial in septic patients. Sepsis data supports that there is a higher risk of mortality for each hour delay from triage to antibiotic therapy, as well as for inappropriate antibiotic selection. There are a variety of rapid microbial detection systems, such as VERIGENE®, used in acute care facilities to rapidly detect bacteremia and identify resistance markers. Our study investigates the usefulness of VERIGENE® assays in accurately detecting Gram-positive and Gram-negative pathogens when compared to traditional blood culture analysis systems, such as VITEK®.
819 Gram-positive and 373 Gram-negative blood samples were collected and tested using both VERIGENE® and VITEK®. Statistical tests were two-tailed and observations were defined as statistically significant if P ≤ 0.05.
VERIGENE® detected a pathogen in 816/819 (99.6%) samples of the Gram-positive blood cultures and 367/373 (98.3%) samples of the Gram-negatives compared to 805/819 (98.3%) and 367/373 (98.4%), respectively, using VITEK®. Gram-positive cultures had a sensitivity of 99.5% and a specificity of 27.3% (PPV 99.0%, NPV 42.9%, 98.7% accuracy) with VERIGENE analysis. Gramnegatives had a sensitivity of 99.2% and a specificity of 20.0% (PPV 98.9%, NPV 25.0%, 98.4% accuracy).
Although statistically insignificant (P = 0.25), VERIGENE® was 1.3% more likely to identify Gram-positive bacteria when compared to conventional methods. Overall, we concluded that VERIGENE® assays are valuable in their ability to rapidly detect microorganisms and resistance markers, given their high sensitivities. This allows for select targeted therapy in patients with sepsis and can ultimately reduce mortality rates.
在脓毒症患者中，快速给予适当的抗生素至关重要。脓毒症数据表明，从分诊到抗生素治疗的每延迟一小时，死亡率的风险就会增加，而且抗生素的选择也不合适。有各种各样的快速微生物检测系统，如 VERIGENE®，用于急性护理设施，以快速检测菌血症并识别耐药标记物。我们的研究调查了 VERIGENE®检测与传统血液培养分析系统（如 VITEK®）相比，在准确检测革兰氏阳性和革兰氏阴性病原体方面的有用性。
收集了 819 份革兰氏阳性和 373 份革兰氏阴性血液样本，并分别使用 VERIGENE®和 VITEK®进行检测。统计检验为双侧检验，如果 P≤0.05，则定义为具有统计学意义。
与 VITEK®相比，VERIGENE®在革兰氏阳性血培养的 816/819（99.6%）和革兰氏阴性血培养的 367/373（98.3%）样本中检测到病原体，而 VITEK®则分别为 805/819（98.3%）和 367/373（98.4%）。革兰氏阳性培养的敏感性为 99.5%，特异性为 27.3%（PPV 99.0%，NPV 42.9%，98.7%准确率），VERIGENE 分析的特异性为 99.2%，特异性为 20.0%（PPV 98.9%，NPV 25.0%，98.4%准确率）。
尽管统计学上无显著差异（P=0.25），但与传统方法相比，VERIGENE®更有可能识别革兰氏阳性细菌。总的来说，我们得出结论，VERIGENE®检测在快速检测微生物和耐药标记物方面具有很高的敏感性，因此具有很高的价值。这使得脓毒症患者能够进行有针对性的选择治疗，最终降低死亡率。
