Comparison of Rapid Antibiotic Susceptibility Test Method Directly from Blood Culture Bottle with Standard Disc Diffusion Method
Abstract
Aim: Early determination of antimicrobial susceptibility of sepsis pathogens is important. In this study, we aimed to compare the standard disc diffusion method with the rapid antimicrobial susceptibility testing (RAST) method performed directly from blood culture bottles.
Material and Methods: Bacteria isolated from samples that gave a positive signal on the blood culture device between April 2019 and September 2019 were included in the study, and antimicrobial susceptibilities were determined by the standard disc diffusion method and the RAST method. Categorical agreement, small error, large error, very large error, and area of technical uncertainty ratios were recorded.
Results: A total of 103 bacteria including 19 S. aureus, 10 Enterococcus spp. and 24 E. coli, 24 K. pneumoniae, 13 P. aeruginosa, and 13 A. baumannii were included in the study. When the RAST method was compared with the standard disc diffusion method, 100% agreement was found between the methods against imipenem, meropenem, gentamicin, and trimethoprim-sulfamethoxazole in E. coli isolates at all hours evaluated, and against meropenem in K. pneumoniae isolates at the 6th and 8th hour. For S. aureus and P. aeruginosa isolates, very major errors were found in the RAST results. For A. baumannii isolates, 100% agreement between methods was observed for many antibiotics.
Conclusion: It was concluded that the RAST method is a simple and inexpensive test for life-threatening infections such as sepsis. It was also felt that similar studies should be carried out with a large number of isolates, as compliance rates vary depending on the bacteria tested.
Keywords
Bacteremia disc diffusion antimicrobial tests EUCAST rapid antimicrobial susceptibility test; blood culture
References
- Chandrasekaran S, Abbott A, Campeau S, Zimmer BL, Weinstein M, Thrupp L, et al. Direct-from-blood-culture disk diffusion to determine antimicrobial susceptibility of gram-negative bacteria: preliminary report from the clinical and laboratory standards ınstitute methods development and standardization working group. J Clin Microbiol. 2018;56(3):e01678-17.
- Boland L, Streel C, De Wolf H, Rodriguez H, Verroken A. Rapid antimicrobial susceptibility testing on positive blood cultures through an innovative light scattering technology: Performances and turnaround time evaluation. BMC Infect Dis. 2019;19(1):989.
- Howell MD, Davis AM. Management of sepsis and septic shock. JAMA. 2017;317(8):847-8.
- Seymour CW, Gesten F, Prescott HC, Friedrich ME, Iwashyn TJ, Phillips GS, et al. Time to treatment and mortality during mandated emergency care for sepsis. N Engl J Med. 2017;376(23):2235-44.
- European Committee on Antimicrobial Susceptibility Testing. Methodology - EUCAST rapid antimicrobial susceptibility testing (RAST) directly from positive blood culture bottles, version 1.1, 2019. Available from: eucast.org/rapid-ast-in-bloodcultures/methods.
- Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966;45(4):493-6.
- European Committee on Antimicrobial Susceptibility Testing. Disk diffusion method for antimicrobial susceptibility testing, version 7.0, 2019. Available from: eucast.org/ast_of_bacteria/disk_diffusion_methodology.
- European Committee on Antimicrobial Susceptibility Testing. Zone diameter breakpoints for rapid antimicrobial susceptibility testing (RAST) directly from blood culture bottles, version 2.0, 2020. Available from: eucast.org/rapid _ast_in_blood_cultures/breakpoints_for_short_incubation.
- Jasuja JK, Zimmermann S, Burckhardt I. Evaluation of EUCAST rapid antimicrobial susceptibility testing (RAST) for positive blood cultures in clinical practice using a total lab automation. Eur J Clin Microbiol Infect Dis. 2020;39(7):1305-13.
- Dubourg G, Lamy B, Ruimy R. Rapid phenotypic methods to improve the diagnosis of bacterial bloodstream infections: meeting the challenge to reduce the time to result. Clin Microbiol Infect. 2018;24(9):935-43.
- Soo YT, Waled SNMB, Ng S, Peh YH, Chew KL. Evaluation of EUCAST rapid antimicrobial susceptibility testing (RAST) directly from blood culture bottles. Eur J Clin Microbiol Infect Dis. 2020;39(5):993-8.
- Erdoğan G, Karakoç AE, Yücel M, Yağci S. Evaluation of EUCAST direct rapid antimicrobial susceptibility test method in blood culture bottles with positive signal. Mikrobiyol Bul. 2021;55(4):626-34. Turkish.
- Cao M, Huang L, Hu Y, Fang Y, Zhang R, Chen G. Development of an in-house rapid antimicrobial susceptibility testing protocol for positive blood culture and its implementation in routine microbiology laboratories. Front Microbiol. 2021;12:765757.
- Martins A, Wink P, Pereira D, Souza A, Aquino V, Barth A. Rapid antimicrobial susceptibility of Enterobacteriaceae by disk diffusion directly from blood culture bottles using the EUCAST RAST breakpoints. J Glob Antimicrob Resist. 2020;22:637-42.
- Fröding I, Vondracek M, Giske CG. Rapid EUCAST disc diffusion testing of MDR Escherichia coli and Klebsiella pneumoniae: inhibition zones for extended-spectrum cephalosporins can be reliably read after 6 h of incubation. J Antimicrob Chemother. 2017;72(4):1094-102.
- Weme ET. Rapid antimicrobial susceptibility testing of positive blood cultures by direct inoculation and reading of disc diffusion tests after 3-4 hours. APMIS. 2018;126(11):870-6.
- Kansak N, Adaleti R, Nakipoglu Y, Aksaray S. Evaluation of the performance of rapid antibiotic susceptibility test results using the disk diffusion directly from the positive blood culture bottles. Indian J Med Microbiol. 2021;39(4):484-8.
Kan Kültürü Şişesinden Doğrudan Yapılan Hızlı Antibiyotik Duyarlılık Testi Yönteminin Standart Disk Difüzyon Yöntemi ile Karşılaştırılması
Abstract
Amaç: Sepsis etkenlerinin antimikrobiyal duyarlılıklarının erken belirlenmesi çok önemlidir. Bu çalışmada, standart disk difüzyon yöntemi ile kan kültür şişelerinden doğrudan yapılan hızlı antibiyotik duyarlılık testi (HADT) yönteminin karşılaştırılması amaçlandı.
Gereç ve Yöntemler: Çalışmaya Nisan 2019 ile Eylül 2019 tarihleri arasında kan kültürü cihazında pozitif sinyal veren örneklerden izole edilen bakteriler dahil edilmiş ve antimikrobiyal duyarlıkları standart disk difüzyon yöntemi ve HADT yöntemi ile belirlenmiştir. Kategorik uyum, küçük hata, büyük hata, çok büyük hata ve teknik belirsizlik alanı oranları kaydedilmiştir.
Bulgular: Çalışmaya 19’u S. aureus, 10’u Enterococcus spp. ile 24’ü E. coli, 24’ü K. pneumoniae, 13’ü P. Aeruginosa ve 13’ü A. baumannii olmak üzere toplam 103 adet bakteri dahil edilmiştir. HADT yöntemi ile standart disk difüzyon yöntemi karşılaştırıldığında, E. coli izolatlarında imipenem, meropenem, gentamisin ve trimetoprim-sülfametoksazole karşı değerlendirilen tüm saatler için, K. pneumoniae izolatlarında ise meropeneme karşı 6. ve 8. saatler için yöntemler arasında %100 uyum bulunmuştur. S. aureus ve P. aeruginosa izolatlarında ise HADT sonuçlarında çok büyük hata saptanmıştır. A. baumannii izolatlarında birçok antibiyotik için yöntemler arasında %100 uyum olduğu görülmüştür.
Sonuç: HADT yönteminin sepsis gibi hayatı tehdit eden enfeksiyonlar için kullanımı kolay ve ucuz bir test olduğu sonucuna varılmıştır. Test edilen bakteriye göre değişen uyum oranları nedeniyle benzer çalışmaların çok sayıda izolatla yapılması gerektiği de düşünülmüştür.
Keywords
Bakteriyemi disk diffüzyon antimikrobiyal testleri EUCAST hızlı antimikrobiyal duyarlılık testi kan kültürü
References
- Chandrasekaran S, Abbott A, Campeau S, Zimmer BL, Weinstein M, Thrupp L, et al. Direct-from-blood-culture disk diffusion to determine antimicrobial susceptibility of gram-negative bacteria: preliminary report from the clinical and laboratory standards ınstitute methods development and standardization working group. J Clin Microbiol. 2018;56(3):e01678-17.
- Boland L, Streel C, De Wolf H, Rodriguez H, Verroken A. Rapid antimicrobial susceptibility testing on positive blood cultures through an innovative light scattering technology: Performances and turnaround time evaluation. BMC Infect Dis. 2019;19(1):989.
- Howell MD, Davis AM. Management of sepsis and septic shock. JAMA. 2017;317(8):847-8.
- Seymour CW, Gesten F, Prescott HC, Friedrich ME, Iwashyn TJ, Phillips GS, et al. Time to treatment and mortality during mandated emergency care for sepsis. N Engl J Med. 2017;376(23):2235-44.
- European Committee on Antimicrobial Susceptibility Testing. Methodology - EUCAST rapid antimicrobial susceptibility testing (RAST) directly from positive blood culture bottles, version 1.1, 2019. Available from: eucast.org/rapid-ast-in-bloodcultures/methods.
- Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966;45(4):493-6.
- European Committee on Antimicrobial Susceptibility Testing. Disk diffusion method for antimicrobial susceptibility testing, version 7.0, 2019. Available from: eucast.org/ast_of_bacteria/disk_diffusion_methodology.
- European Committee on Antimicrobial Susceptibility Testing. Zone diameter breakpoints for rapid antimicrobial susceptibility testing (RAST) directly from blood culture bottles, version 2.0, 2020. Available from: eucast.org/rapid _ast_in_blood_cultures/breakpoints_for_short_incubation.
- Jasuja JK, Zimmermann S, Burckhardt I. Evaluation of EUCAST rapid antimicrobial susceptibility testing (RAST) for positive blood cultures in clinical practice using a total lab automation. Eur J Clin Microbiol Infect Dis. 2020;39(7):1305-13.
- Dubourg G, Lamy B, Ruimy R. Rapid phenotypic methods to improve the diagnosis of bacterial bloodstream infections: meeting the challenge to reduce the time to result. Clin Microbiol Infect. 2018;24(9):935-43.
- Soo YT, Waled SNMB, Ng S, Peh YH, Chew KL. Evaluation of EUCAST rapid antimicrobial susceptibility testing (RAST) directly from blood culture bottles. Eur J Clin Microbiol Infect Dis. 2020;39(5):993-8.
- Erdoğan G, Karakoç AE, Yücel M, Yağci S. Evaluation of EUCAST direct rapid antimicrobial susceptibility test method in blood culture bottles with positive signal. Mikrobiyol Bul. 2021;55(4):626-34. Turkish.
- Cao M, Huang L, Hu Y, Fang Y, Zhang R, Chen G. Development of an in-house rapid antimicrobial susceptibility testing protocol for positive blood culture and its implementation in routine microbiology laboratories. Front Microbiol. 2021;12:765757.
- Martins A, Wink P, Pereira D, Souza A, Aquino V, Barth A. Rapid antimicrobial susceptibility of Enterobacteriaceae by disk diffusion directly from blood culture bottles using the EUCAST RAST breakpoints. J Glob Antimicrob Resist. 2020;22:637-42.
- Fröding I, Vondracek M, Giske CG. Rapid EUCAST disc diffusion testing of MDR Escherichia coli and Klebsiella pneumoniae: inhibition zones for extended-spectrum cephalosporins can be reliably read after 6 h of incubation. J Antimicrob Chemother. 2017;72(4):1094-102.
- Weme ET. Rapid antimicrobial susceptibility testing of positive blood cultures by direct inoculation and reading of disc diffusion tests after 3-4 hours. APMIS. 2018;126(11):870-6.
- Kansak N, Adaleti R, Nakipoglu Y, Aksaray S. Evaluation of the performance of rapid antibiotic susceptibility test results using the disk diffusion directly from the positive blood culture bottles. Indian J Med Microbiol. 2021;39(4):484-8.
Details
| Primary Language | English |
|---|---|
| Subjects | Medical Bacteriology |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | March 16, 2024 |
| Publication Date | April 30, 2024 |
| Submission Date | October 22, 2023 |
| Acceptance Date | February 10, 2024 |
| Published in Issue | Year 2024 Volume: 26 Issue: 1 |
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