Payen Mathilde, Gaudart Alice, Legueult Kevin, Kasprzak James, Emery Audrey, Mutambayi Grégoire, Pradier Christian, Robin Frédéric, Lotte Romain, Ruimy Raymond
Laboratoire de Bactériologie, Hôpital L'Archet 2, Centre Hospitalier Universitaire de Nice, 06000 Nice, France.
Institut National de la Santé et de la Recherche Médicale U1065, Centre Méditerranéen de Médecine Moléculaire, Équipe 6, 06200 Nice, France.
Microorganisms. 2022 Jul 8;10(7):1377. doi: 10.3390/microorganisms10071377.
bloodstream infections are life-threatening and require rapid, targeted antibiotherapy based on antibiotic susceptibility testing (AST). A new method using Muller-Hinton Rapid-SIR (MHR-SIR) agar (i2a, Montpellier, France) allows complete direct AST (dAST) to be read from positive blood culture bottles (BCBs) for all species after 6-8 h of incubation. We evaluated (i) the performance of dAST from positive BCBs on MHR-SIR agar using two different inoculum protocols; (ii) the categorical agreement between dAST results obtained with MHR-SIR agar vs. those obtained with Muller-Hinton (MH) agar; and (iii) the ability of the MHR-SIR medium to detect β-lactam resistant Finally, we estimated the saved turnaround time (TAT) with MHR-SIR compared with MH agar in our 24/7 laboratory. Our results showed that the most suitable inoculation protocol for dAST on MHR-SIR agar was 1 drop of BCB/5 mL HO. For monomicrobial BCBs, dAST performed on MHR-SIR medium showed 99.3% categorical agreement with AST on MH agar. Furthermore, MHR-SIR agar allows early detection of β-lactam resistance mechanisms, including AmpC hyperproduction, extended-spectrum β-lactamase, and carbapenemase. Finally, TAT reduction in our 24/7 laboratory was 16 h, enabling a significantly faster provision of antibiotic advice.
血流感染会危及生命，需要根据抗生素敏感性试验（AST）进行快速、有针对性的抗菌治疗。一种使用Muller-Hinton快速药敏（MHR-SIR）琼脂（i2a公司，法国蒙彼利埃）的新方法，能够在孵育6 - 8小时后，直接从阳性血培养瓶（BCB）中读取所有菌种的完整直接药敏试验（dAST）结果。我们评估了：（i）使用两种不同接种方案，在MHR-SIR琼脂上从阳性BCB进行dAST的性能；（ii）MHR-SIR琼脂获得的dAST结果与Muller-Hinton（MH）琼脂获得的结果之间的类别一致性；以及（iii）MHR-SIR培养基检测β-内酰胺耐药性的能力。最后，我们估计了在我们全天候运行的实验室中，与MH琼脂相比，MHR-SIR节省的周转时间（TAT）。我们的结果表明，在MHR-SIR琼脂上进行dAST最合适的接种方案是1滴BCB/5 mL水。对于单一微生物的BCB，在MHR-SIR培养基上进行的dAST与在MH琼脂上进行的AST显示出99.3%的类别一致性。此外，MHR-SIR琼脂能够早期检测β-内酰胺耐药机制，包括AmpC高产、超广谱β-内酰胺酶和碳青霉烯酶。最后，我们全天候运行的实验室中的TAT减少了1
