Evaluation of the Vitek® Reveal™ system for rapid antimicrobial susceptibility testing of Gram-negative pathogens, including ESBL, CRE and CRAB, from positive blood cultures.
Alberto AntonelliSara CuffariBenedetta CasciatoTommaso GianiGian Maria RossoliniPublished in: Diagnostic microbiology and infectious disease (2024)
Blood culture (BC) remains the reference diagnostic tool for bloodstream infections but is hampered by long turn-around time (TAT). This study evaluated the Vitek® Reveal™ (VR) system for rapid antimicrobial susceptibility testing (AST) with 72 cases of monomicrobial BCs (55 Enterobacterales, 12 Pseudomonas aeruginosa and 5 Acinetobacter baumannii), including isolates producing carbapenemases and/or extended-spectrum β-lactamases. VR returned AST results with a mean TAT of 5.4 h. Compared to a conventional workflow based on broth microdilution, VR exhibited essential agreement (EA) and category agreement (CA) >90 % in most cases, except with meropenem for Enterobacterales (CA, 85.5 %), piperacillin/tazobactam for P. aeruginosa (EA, 83.3 %), and trimethoprim/sulfamethoxazole for A. baumannii (CA and EA, 80 %). Bias exhibited an underestimation trend with ceftazidime/avibactam (-78.9 %) and ceftazidime (-50 %) for Enterobacterales and P. aeruginosa, respectively. Overall, VR appears an interesting tool to decrease TAT of the BC workflow, although further evaluation with some antibiotic-pathogen combinations would be warranted.
Keyphrases
- gram negative
- multidrug resistant
- acinetobacter baumannii
- klebsiella pneumoniae
- virtual reality
- drug resistant
- pseudomonas aeruginosa
- genome wide
- protein kinase
- single cell
- escherichia coli
- loop mediated isothermal amplification
- cystic fibrosis
- electronic health record
- sensitive detection
- gene expression
- fluorescent probe
- candida albicans
- dna methylation
- staphylococcus aureus
- antibiotic resistance genes
- wastewater treatment
- genetic diversity