快速病原体鉴定和抗微生物药敏试验的新方法与常规血培养诊断方法的比较,Letters in Applied Microbiology

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快速病原体鉴定和抗微生物药敏试验的新方法与常规血培养诊断方法的比较
Letters in Applied Microbiology ( IF 2.0 ) Pub Date : 2021-03-31 , DOI: 10.1111/lam.13481
L Knabl ₁ , S Huber ₁ , C Lass-Flörl ₁ , S Fuchs ₁

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血流感染对临床医生构成重大挑战，因为立即应用适当的抗生素治疗是确保患者生命安全的重要因素。这项初步研究比较了三种不同的系统，与传统血培养 (BC) 相比，有希望进行快速病原体鉴定和药敏试验：(i) 根据 EUCAST 的快速抗菌药敏试验方案与 Sepsityper ^®试剂盒 (sRAST)相结合，(ii) VITEK ^® 2 系统 (dVIT)上的直接接种方法和 (iii) 使用 Accelerate Pheno ^{® 进行}测试系统 (AccPh)。所有方法都在准确性、结果时间和可用性方面进行了评估。详细分析了从患有败血症的患者身上获得的 23 份 BC 样本。sRAST、dVIT和AccPh的病原体鉴定成功率分别为95·6、91·3和91·3%。抗菌药物敏感性试验的绝对一致性分别为 89·5、96 和 96·6%。从样本输入到报告的时间范围从 sRAST 的平均 4·6 小时和 AccPh 的 6·9 小时到 dVIT 的 10·6 小时不等。这些结果意味着这些新诊断方法在相当高的一致率下显着缩短了报告时间。

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Comparison of novel approaches for expedited pathogen identification and antimicrobial susceptibility testing against routine blood culture diagnostics

Blood stream infections pose a major challenge for clinicians as the immediate application of an appropriate antibiotic treatment is the vital factor to safe the patients' lives. This preliminary study compares three different systems promising fast pathogen identification and susceptibility testing in comparison to conventional blood culture (BC): (i) the rapid antimicrobial susceptibility testing protocol according to EUCAST in combination with the Sepsityper^® kit (sRAST), (ii) the direct inoculation method on the VITEK^®2 system (dVIT) and (iii) testing with the Accelerate Pheno^® system (AccPh). All methods were assessed in terms of accuracy, time to result and usability. Twenty-three BC samples obtained from patients suffering from proven sepsis were analysed in detail. Pathogen identification was successful in 95·6, 91·3 and 91·3% in sRAST, dVIT and AccPh, respectively. Categorical agreement in antimicrobial susceptibility testing was 89·5, 96 and 96·6%, respectively. Time to result from sample entry to reporting ranged from an average of 4·6 h for sRAST and 6·9 h for AccPh to 10·6 h for dVIT. These results imply a significant shortening of reporting times at considerably high agreement rates for these new diagnostic approaches.

更新日期：2021-03-31

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