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Antimicrobial susceptibility testing (AST) from blood culture (BC) may take several days, limiting the eventual impact on antimicrobial stewardship. Hence, rapid AST systems represent a valuable support in shorting the time-to-response. In this work, the Quantamatrix dRAST system (dRAST) was evaluated for rapid AST on 100 monomicrobial BCs (50 Gram-negatives and 50 Gram-positives), including several isolates with clinically relevant resistance mechanisms. AST results were provided in 6-hours, on average. Compared to Micronaut (Merlin) system based on broth microdilution, dRAST exhibited an overall categorical agreement of 92.5 %, essential agreement of 89.0 %, and mean bias of 15.9 %. Category overestimation (potentially leading to unnecessary high-dosage treatment or to exclude active agents) and category underestimation (potentially leading to underdosing or using ineffective agents) were observed in 4.3 % and 3.1 % of cases, respectively. Even though several issues were reported, results confirmed the potential contribution of dRAST to shorten the BCs clinical microbiology workflow and management.
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| http://dx.doi.org/10.1016/j.diagmicrobio.2024.116436 | DOI Listing |
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A comparative study of a rapid phenotypic antimicrobial susceptibility testing system directly from positive blood cultures to the disk diffusion and VITEK 2 methods.
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Article Synopsis
- There is a pressing need for quick antimicrobial susceptibility testing (AST) for bacteria responsible for bloodstream infections (BSIs), as timely results can guide effective treatment.
- The study evaluates the dRAST method, which analyzes positive blood cultures and uses a prescreening algorithm to select relevant samples, comparing its results with the established EUCAST disk diffusion method.
- Out of 242 tested clinical samples, dRAST showed a high agreement rate (95.5%) with the disk diffusion method, although its reliability varied for certain antibiotic-bacteria combinations, particularly with multidrug resistant isolates (87.2% agreement).
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