Performance evaluation of Alfred60AST rapid susceptibility testing directly from positive blood cultures in the routine laboratory workflow
- 17 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Microbiology & Infectious Diseases
- Vol. 40 (7), 1487-1494
- https://doi.org/10.1007/s10096-021-04191-9
Abstract
The aim of this study was to evaluate the performance of the new automated system Alfred60AST which is based on light scattering technology for rapid susceptibility testing directly from positive blood cultures as well as its applicability in the routine laboratory workflow. We evaluated 176 significant episodes of bacteremia due to 92 Gram-negative and 84 Gram-positive bacteria. The antimicrobial agents tested were ceftriaxone, ciprofloxacin, gentamicin, meropenem, piperacillin-tazobactam, and colistin for Gram negatives and cefoxitin, vancomycin, linezolid, and daptomycin for Gram positives. Concordance assessment was performed in comparison with our routine method, Vitek2 (bioMérieux). Discrepancies were resolved with MICRONAUT-S (Merlin) or E-test (bioMérieux). Out of 690 susceptibility determinations, 94.05% showed categorical agreement (CA) with the routine method and this percentage increased to 94.49 after discrepancy analysis. There were 1.45% very major errors, 3.33% major errors, and 1.16% minor errors (decreased to 1.45, 3.04, and 1.01 after discrepancy analysis). The CA for most of the antibiotics was above 90% except for daptomycin for Gram positives (87.30%) and ceftriaxone for Gram negatives (88.23%). The concordance was slightly better for Gram negative than for Gram-positive bacteria (94.30 versus 93.70%, respectively). The total turnaround time for a complete Alfred60AST result was 6–6.5h. The evaluated method gave rapid and reliable results in a few hours, versus 48h for the conventional one. Implementing this technology in routine workflow allows clinicians to optimize the treatment on the same day of blood culture positivity with potential positive clinical benefits and impact on antibiotic stewardship.Keywords
This publication has 22 references indexed in Scilit:
- Diagnosis of bloodstream infections from positive blood cultures and directly from blood samples: recent developments in molecular approachesClinical Microbiology & Infection, 2018
- A Prospective Evaluation of Two Rapid Phenotypical Antimicrobial Susceptibility Technologies for the Diagnostic Stewardship of SepsisBioMed Research International, 2018
- Rapid diagnostics for bloodstream infections: A primer for infection preventionistsAmerican Journal of Infection Control, 2018
- Evaluation of the Accelerate Pheno System: Results from Two Academic Medical CentersJournal of Clinical Microbiology, 2018
- Use of the Accelerate Pheno System for Identification and Antimicrobial Susceptibility Testing of Pathogens in Positive Blood Cultures and Impact on Time to Results and WorkflowJournal of Clinical Microbiology, 2018
- Advances in Rapid Identification and Susceptibility Testing of Bacteria in the Clinical Microbiology Laboratory: Implications for Patient Care and Antimicrobial Stewardship ProgramsInfectious Disease Reports, 2017
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016Critical Care Medicine, 2017
- A new rapid method for direct antimicrobial susceptibility testing of bacteria from positive blood culturesBMC Microbiology, 2016
- Update on blood cultures: how to obtain, process, report, and interpretClinical Microbiology & Infection, 2013
- Initiation of Inappropriate Antimicrobial Therapy Results in a Fivefold Reduction of Survival in Human Septic ShockSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2009