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快速微生物系统在革兰氏阴性杆菌菌血症快速诊断中的评价。

Evaluation of the quickmic system in the rapid diagnosis of Gram-negative bacilli bacteremia.

机构信息

Department of Microbiology, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.

Infectious Diseases Unit, Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.

出版信息

Microbiol Spectr. 2024 Oct 3;12(10):e0401123. doi: 10.1128/spectrum.04011-23. Epub 2024 Aug 28.

Abstract

UNLABELLED

Rapid microbiological diagnosis of the antibiotic susceptibility of Gram-negative bacilli is a priority in clinical microbiology, especially in cases of bacteremia. The rapid advancement of antimicrobial resistance proposes a challenge for empirical antibiotic therapy and shows the need for fast antibiotic susceptibility diagnostics to guide treatments. The QuickMIC System (Gradientech AB, Uppsala, Sweden) is a recently developed rapid diagnostic tool for antibiotic susceptibility testing. Our study evaluates a rapid phenotypic system (QuickMIC) that provides information on the susceptibility of 12 antibiotics against , ., , , , ., and . A total of 816 antibiotic/microorganism combinations were tested, resulting in eight discrepancies. The concordance between the antibiotics offered by QuickMIC and reference methods (MicroScan WalkAway plus system, Beckman Coulter; Etest (BioMerieux microdilution system (Bruker); Real-time PCR (GeneXpert, Cepheid); and immunochromatography (Biotech) was 99.02%. Time elapsed to obtain a valid minimal inhibitory concentration (MIC) was between 2 and 4 h. The QuickMIC system allows for the early adjustment of antibiotic treatment in these infections. Given the existing limitations of currently available rapid methods, its clinical utility is particularly relevant in the management of infections and AmpC-producing Enterobacterales. The use of rapid methods can help diversify antibiotic use and reduce carbapenem consumption.

IMPORTANCE

The rapid diagnosis of antibiotic sensitivity in Gram-negative bacilli is of paramount importance in clinical microbiology, particularly in cases of bacteremia. The escalating challenge of antimicrobial resistance underscores the need for expeditious antibiotic susceptibility diagnostics to guide empirical antibiotic therapy effectively. In light of this, we present our study that evaluates the QuickMIC System, a recently developed rapid diagnostic antibiogram. QuickMIC System, offers a novel approach to phenotypic testing, providing information on the activity of 12 antibiotics against key pathogens, including , ., , , , ., ., and . Our investigation involved testing a total of 816 antibiotic/microorganism combinations. The study demonstrated an impressive 99.02% concordance between the QuickMIC System and the reference methods, with only eight discrepancies observed. The time to actionable minimum inhibitory concentration (MIC) ranged between 2 and 4 h, highlighting the system's efficiency in providing rapid results.

摘要

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革兰氏阴性杆菌的抗生素敏感性快速微生物学诊断是临床微生物学的当务之急,尤其是在菌血症的情况下。抗生素耐药性的快速发展对经验性抗生素治疗提出了挑战,并表明需要快速的抗生素敏感性诊断来指导治疗。QuickMIC 系统(Gradientech AB,乌普萨拉,瑞典)是一种最近开发的抗生素敏感性测试快速诊断工具。我们的研究评估了一种快速表型系统(QuickMIC),该系统提供了对 12 种抗生素对 、 、 、 、 、 、 和 的药敏信息。总共测试了 816 种抗生素/微生物组合,结果有 8 个差异。QuickMIC 提供的抗生素与参考方法(MicroScan WalkAway plus 系统,贝克曼库尔特;Etest(BioMerieux 微量稀释系统(布鲁克);实时 PCR(GeneXpert,Cepheid);和免疫色谱法(Biotech)之间的一致性为 99.02%。获得有效最小抑菌浓度(MIC)的时间在 2 至 4 小时之间。QuickMIC 系统允许在这些感染中早期调整抗生素治疗。鉴于目前可用的快速方法存在局限性,其临床实用性在管理 感染和产 AmpC 的肠杆菌科细菌感染方面尤为重要。快速方法的使用可以帮助多样化抗生素的使用并减少碳青霉烯类药物的消耗。

重要性

革兰氏阴性杆菌抗生素敏感性的快速诊断在临床微生物学中至关重要,尤其是在菌血症的情况下。抗生素耐药性的挑战日益加剧,突显了有效指导经验性抗生素治疗的快速抗生素敏感性诊断的必要性。有鉴于此,我们介绍了我们的研究,该研究评估了最近开发的快速诊断药敏谱的 QuickMIC 系统。QuickMIC 系统提供了一种新的表型测试方法,可提供针对关键病原体(包括 、 、 、 、 、 、和 )的 12 种抗生素活性的信息。我们的研究总共测试了 816 种抗生素/微生物组合。研究表明,QuickMIC 系统与参考方法之间具有令人印象深刻的 99.02%一致性,仅观察到 8 个差异。达到可行动性最小抑菌浓度(MIC)的时间在 2 至 4 小时之间,突出了该系统在提供快速结果方面的效率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f26/11448121/6c16ef679a33/spectrum.04011-23.f001.jpg

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