Assessment of version 2.5 of QMAC-dRAST for rapid antimicrobial susceptibility testing with reduced sample-to-answer turnaround time and an integrated expert system - 05/08/21
, Simon Picard, Jean-Luc Mainardi, Isabelle PodglajenBienvenue sur EM-consulte, la référence des professionnels de santé.
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| pages | 7 |
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Highlights |
• | The accuracy of the QMAC-dRAST V2.5 for AST results is similar to that of QMAC-dRAST V2.0. |
• | The time required to obtain AST results using QMAC-dRAST V2.5 has been reduced. |
• | The expert system takes natural antibiotic resistances into account. |
Abstract |
Objective |
To assess the performance of the new rapid antimicrobial susceptibility testing (AST) QMAC-dRAST V2.5 system.
Methods |
ASTs were performed using QMAC-dRAST-V2.5 and a disk diffusion method, directly from positive blood bottles with Gram-negative bacteria. Discrepancies between the results obtained using the two methods were categorized into very major errors (VME, S with dRAST vs. R with disk diffusion), major errors (ME, R vs. S, respectively), minor errors (mE, S vs. I or I vs. R, respectively), and very minor errors (Vme, I vs. S or R vs. I, respectively). For each AST, results were recorded after 4, 5, and 6h of incubation.
Results |
From 106 bacteremia, 1416 individual AST results were obtained. Overall agreement between results using the two methods was 91%, ranging from 76.9% to 99.1% depending upon the antibiotic, with 128 errors, i.e. 14/1416 (1%) VME, 59/1416 (4.2%) ME, 25/1416 (1.8%) mE and 30/1416 (2.1%) Vme. VMEs were encountered for Klebsiella sp and Serratia marcescens isolates with low-level piperacillin and amikacin resistance, respectively. Using the integrated QMAC-dRAST-V2.5 expert system, all 14 VMEs and 3 mEs were eliminated, leading to 92.2% categorical agreement. After 45min of pre-incubation in the QMAC-dRAST-V2.5 device, 22.2% of the 1416 AST results were obtained after 4h, an additional 31.4% after 5h and a further 46.3% after 6h.
Conclusion |
QMAC-dRAST-V2.5 is an optimized version of QMAC-dRAST V2.0, particularly with respect to utilization of an expert system and reduced TAT according to the antibiotic tested.
Le texte complet de cet article est disponible en PDF.Keywords : QMAC-dRAST, Automated antimicrobial susceptibility testing, Gram-negative bacteria, Blood culture, Bacteremia
Plan
Vol 51 - N° 5
P. 470-476 - août 2021 Retour au numéro
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