Zalas-Więcek Patrycja, Bogiel Tomasz, Gospodarek-Komkowska Eugenia
Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University (NCU) in Toruń, 85-094 Bydgoszcz, Poland.
Clinical Microbiology Division, University Hospital No. 1 in Bydgoszcz, 85-094 Bydgoszcz, Poland.
Pathogens. 2022 Nov 24;11(12):1415. doi: 10.3390/pathogens11121415.
The aim of this study was to evaluate the usefulness of the Accelerate Pheno™ system (APS) (Accelerate Diagnostics, Denver, CO, USA) for rapid laboratory diagnosis of bloodstream infections. The study included 45 positive blood samples obtained from patients hospitalized in University Hospital No. 1 in Bydgoszcz, Poland. In 40 (88.9%) blood samples, the APS was capable of identification of at least one microorganism at the genus or species level and in 38 (84.4%) of them additionally assessed antimicrobial susceptibility. The time of identification and the time to result of antimicrobial susceptibility ranged from 1:32 to 1:42 and 5:02 to 5:36 h, respectively. Six positive blood samples revealed a poly-microbial culture. In these cases, only one out of two or three microorganisms was detected by the APS, and the system assessed antimicrobial susceptibility only for them. For 78.6% positive blood samples, agreement on identification compared to mass spectrometry was found. For all but one sample, a 96-100% compliance of the resistance category was achieved when comparing the antimicrobial susceptibility testing results to conventional methods. Using the APS, the total time to report was reduced from 13:34 to even 63:47 h compared to the standard microbiological laboratory workflow. The APS is a very useful system, especially for the rapid assessment of antimicrobial susceptibility of bacteria directly from positive blood samples, offering the greatest potential for microbiology laboratories operating around the clock.
本研究的目的是评估Accelerate Pheno™系统（APS）（美国科罗拉多州丹佛市的Accelerate Diagnostics公司）在血流感染快速实验室诊断中的实用性。该研究纳入了从波兰比得哥什第一大学医院住院患者中采集的45份阳性血样。在40份（88.9%）血样中，APS能够在属或种水平鉴定出至少一种微生物，其中38份（84.4%）还评估了抗菌药物敏感性。鉴定时间和抗菌药物敏感性结果报告时间分别为1:32至1:42小时和5:02至5:36小时。6份阳性血样显示为多微生物培养。在这些病例中，APS仅检测到两三种微生物中的一种，且该系统仅对检测到的微生物评估抗菌药物敏感性。78.6%的阳性血样在鉴定结果上与质谱法一致。除一份样本外，将抗菌药物敏感性测试结果与传统方法进行比较时，耐药类别符合率达到96 - 100%。与标准微生物实验室工作流程相比，使用APS后报告总时间从13:34小时缩短至甚至63:47小时。APS是一个非常有用的系统，尤其对于直接从阳性血样中快速评估细菌的抗菌药物敏感性，为全天候运行的微生物实验室提供了最大潜力。
