Evaluation of direct inoculation of the BD PHOENIX system from positive BACTEC blood cultures for both Gram-positive cocci and Gram-negative rods

BMC Microbiology

Research Article

Petra FG Wolffs¹  Christina FM van der Donk¹  Judith Beuving¹  Catharina FM Linssen¹  Annelies Verbon² 

[1] Department of Medical Microbiology, Care And Public Health Research Institute (CAPHRI), Maastricht University Medical Center, PO Box 5800, 6202AZ, Maastricht, the Netherlands;Department of Medical Microbiology, Care And Public Health Research Institute (CAPHRI), Maastricht University Medical Center, PO Box 5800, 6202AZ, Maastricht, the Netherlands;Department of Internal Medicine, Erasmus University Medical Center, PO Box 2040, 3000CA, Rotterdam, the Netherlands;

关键词: Bloodstream Infection;    Positive Blood Culture;    Major Error;    Antibiotic Susceptibility Testing;    Blood Culture Bottle;   

DOI  :  10.1186/1471-2180-11-156

 received in 2011-01-14, accepted in 2011-06-30,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundRapid identification (ID) and antibiotic susceptibility testing (AST) of the causative micro-organism of bloodstream infections result in earlier targeting of antibiotic therapy.In order to obtain results of ID and AST up to 24 hours earlier, we evaluated the accuracy of direct inoculation of the Phoenix system from positive blood cultures (BACTEC) by using Serum Separator Tubes to harvest bacteria from positive blood cultures. Results were compared to those of standard Phoenix procedure. Discrepancies between the two methods were resolved by using the API system, E-test or microbroth dilution.ResultsID with the direct method was correct for 95.2% of all tested Enterobacteriaceae (n = 42) and 71.4% of Pseudomonas aeruginosa strains (n = 7).AST with the direct method showed a categorical agreement for Gram-negative rods (GNR) of 99.0%, with 0.7% minor errors, 0.3% very major errors and no major errors. All antibiotics showed an agreement of >95%.The direct method for AST of Staphylococcus (n = 81) and Enterococcus (n = 3) species showed a categorical agreement of 95.4%, with a minor error rate of 1.1%, a major error rate of 3.1% and a very major error rate of 0.4%. All antibiotics showed an agreement of >90%, except for trimethoprim-sulfamethoxazole and erythromycin.ConclusionsInoculation of Phoenix panels directly from positive blood cultures can be used to report reliable results of AST of GNR a day earlier, as well as ID-results of Enterobacteriaceae. For Staphylococcus and Enterococcus species, results of AST can also be reported a day earlier for all antibiotics, except for erythromycin and trimethoprim-sulfamethoxazole.

【 授权许可】

Unknown   
© Beuving et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.