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Assessment of rapid direct E-test on positive blood culture for same-day antimicrobial susceptibility.

Authors
  • Bianco, Gabriele1
  • Iannaccone, Marco2
  • Boattini, Matteo1
  • Cavallo, Rossana1
  • Costa, Cristina1
  • 1 Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Turin, Italy. , (Italy)
  • 2 Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Turin, Italy. [email protected] , (Italy)
Type
Published Article
Journal
Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]
Publication Date
Oct 01, 2019
Volume
50
Issue
4
Pages
953–959
Identifiers
DOI: 10.1007/s42770-019-00139-6
PMID: 31432464
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Early and appropriated antimicrobial therapy showed to positively impact on the clinical improvement of septic patients. The aim of this study was to evaluate E-test methodology to obtain rapid results of antimicrobial susceptibility, starting directly from blood culture bottles positive to Gram-negative monomicrobial flora. One hundred and five blood culture samples positive to Gram-negative rods at the microscopic examination were collected. Bacterial identification from early subculture on blood agar after 4 h incubation and rapid direct E-test from blood culture broth were performed on every sample. Antibiotics MIC were achieved after 5-6 h of incubation. Resulting MIC values were compared with those obtained with reference E-test from the overnight subculture. Categorical agreement (CA) and essential agreement (EA) were evaluated. Comparison between rapid direct E-test and reference E-test showed CA ranging from 95.1 to 100 % and 88.2 to 100 % for Enterobacteriaceae (EB) and for non-fermenting Gram-negative bacilli, respectively. Rapid direct E-test showed an overall EA of 80.1 %, revealing different EA rates for the tested antibiotics. Among carbapenemase-producing EB, CA of 87.5 % and EA of 75.5 % for MP were achieved. The same-day communication of the antimicrobial susceptibility represents an important challenge in the multidrug-resistance era. Despite not being able to anticipate actual MIC values, the rapid direct E-test may be useful to obtain preliminary AST results in 5-6 h, especially if used in association with phenotypic or genotypic tests to identify the main resistance mechanisms.

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