Multicenter Evaluation of the Accelerate PhenoTest BC Kit for Rapid Identification and Phenotypic Antimicrobial Susceptibility Testing Using Morphokinetic Cellular Analysis. J Clin Microbiol 2018 Apr;56(4)
Date
01/07/2018Pubmed ID
29305546Pubmed Central ID
PMC5869823DOI
10.1128/JCM.01329-17Scopus ID
2-s2.0-85044779516 (requires institutional sign-in at Scopus site) 163 CitationsAbstract
We describe results from a multicenter study evaluating the Accelerate Pheno system, a first of its kind diagnostic system that rapidly identifies common bloodstream pathogens from positive blood cultures within 90 min and determines bacterial phenotypic antimicrobial susceptibility testing (AST) results within ∼7 h. A combination of fresh clinical and seeded blood cultures were tested, and results from the Accelerate Pheno system were compared to Vitek 2 results for identification (ID) and broth microdilution or disk diffusion for AST. The Accelerate Pheno system accurately identified 14 common bacterial pathogens and two Candida spp. with sensitivities ranging from 94.6 to 100%. Of fresh positive blood cultures, 89% received a monomicrobial call with a positive predictive value of 97.3%. Six common Gram-positive cocci were evaluated for ID. Five were tested against eight antibiotics, two resistance phenotypes (methicillin-resistant Staphylococcus aureus and Staphylococcus spp. [MRSA/MRS]), and inducible clindamycin resistance (MLSb). From the 4,142 AST results, the overall essential agreement (EA) and categorical agreement (CA) were 97.6% and 97.9%, respectively. Overall very major error (VME), major error (ME), and minor error (mE) rates were 1.0%, 0.7%, and 1.3%, respectively. Eight species of Gram-negative rods were evaluated against 15 antibiotics. From the 6,331 AST results, overall EA and CA were 95.4% and 94.3%, respectively. Overall VME, ME, and mE rates were 0.5%, 0.9%, and 4.8%, respectively. The Accelerate Pheno system has the unique ability to identify and provide phenotypic MIC and categorical AST results in a few hours directly from positive blood culture bottles and support accurate antimicrobial adjustment.
Author List
Pancholi P, Carroll KC, Buchan BW, Chan RC, Dhiman N, Ford B, Granato PA, Harrington AT, Hernandez DR, Humphries RM, Jindra MR, Ledeboer NA, Miller SA, Mochon AB, Morgan MA, Patel R, Schreckenberger PC, Stamper PD, Simner PJ, Tucci NE, Zimmerman C, Wolk DMAuthors
Blake W. Buchan PhD Professor in the Pathology and Laboratory Medicine department at Medical College of WisconsinNathan A. Ledeboer PhD Chief, Professor in the Pathology and Laboratory Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Anti-Bacterial AgentsBlood Culture
Disk Diffusion Antimicrobial Tests
Gram-Negative Bacteria
Gram-Negative Bacterial Infections
Gram-Positive Bacteria
Gram-Positive Bacterial Infections
Humans
Methicillin-Resistant Staphylococcus aureus
Microbial Sensitivity Tests
Phenotype
Reagent Kits, Diagnostic
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
