Direct antimicrobial susceptibility testing of positive blood cultures: a comparison of the Accelerate Pheno™ and VITEK® 2 systems

Jack G. Schneider, James B. Wood, Nathan W. Smith, Christopher Emery, Thomas Davis, John J. Manaloor, Brittany Bocian, Bryan Schmitt

Research output: Contribution to journalArticle

Abstract

Objectives: To compare the performance and time-to-result (TTR) for antimicrobial susceptibility testing (AST) of positive blood cultures (PBC) using the Accelerate Pheno™ system (AXDX) and both a direct VITEK® 2 card inoculation workflow (DV2) and traditional FDA-approved VITEK® 2 workflow using subcultured isolates (V2). Methods: Patient samples with monomicrobial Gram-negative rod bacteremia were tested on AXDX and DV2 in tandem and compared to V2 AST results. Categorical agreement (CA) errors were adjudicated using broth microdilution. Instrumentation times and AST TTR were compared. Results: AXDX and DV2 had a CA of 93.4% and 97.4%, respectively, compared to V2. Postadjudication, AXDX, DV2, and V2 had CA of 94.7%, 95.7%, and 96.5%, respectively. Instrument run times were 6.6 h, 9.4 h, and 9.2 h, and AST TTR were 8.9 h, 12.9 h and 35.5 h, respectively. Conclusions: AXDX and DV2 ASTs are fast and reliable, which may have significant antimicrobial stewardship implications.

Original languageEnglish (US)
Article number114841
JournalDiagnostic Microbiology and Infectious Disease
DOIs
StateAccepted/In press - Jan 1 2019

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Bacteremia
Blood Culture

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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Direct antimicrobial susceptibility testing of positive blood cultures : a comparison of the Accelerate Pheno™ and VITEK® 2 systems. / Schneider, Jack G.; Wood, James B.; Smith, Nathan W.; Emery, Christopher; Davis, Thomas; Manaloor, John J.; Bocian, Brittany; Schmitt, Bryan.

In: Diagnostic Microbiology and Infectious Disease, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Objectives: To compare the performance and time-to-result (TTR) for antimicrobial susceptibility testing (AST) of positive blood cultures (PBC) using the Accelerate Pheno™ system (AXDX) and both a direct VITEK{\circledR} 2 card inoculation workflow (DV2) and traditional FDA-approved VITEK{\circledR} 2 workflow using subcultured isolates (V2). Methods: Patient samples with monomicrobial Gram-negative rod bacteremia were tested on AXDX and DV2 in tandem and compared to V2 AST results. Categorical agreement (CA) errors were adjudicated using broth microdilution. Instrumentation times and AST TTR were compared. Results: AXDX and DV2 had a CA of 93.4{\%} and 97.4{\%}, respectively, compared to V2. Postadjudication, AXDX, DV2, and V2 had CA of 94.7{\%}, 95.7{\%}, and 96.5{\%}, respectively. Instrument run times were 6.6 h, 9.4 h, and 9.2 h, and AST TTR were 8.9 h, 12.9 h and 35.5 h, respectively. Conclusions: AXDX and DV2 ASTs are fast and reliable, which may have significant antimicrobial stewardship implications.",
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