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首页> 外文期刊>Journal of Clinical Microbiology >Evaluation of the Merlin MICRONAUT System for Rapid Direct Susceptibility Testing of Gram-Positive Cocci and Gram-Negative Bacilli from Positive Blood Cultures
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Evaluation of the Merlin MICRONAUT System for Rapid Direct Susceptibility Testing of Gram-Positive Cocci and Gram-Negative Bacilli from Positive Blood Cultures

机译：梅林MICRONAUT系统用于从阳性血液培养物中对革兰氏阳性球菌和革兰氏阴性杆菌进行快速直接药敏试验的评估

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Bloodstream infections are life-threatening conditions which require the timely initiation of appropriate antimicrobial therapy. We evaluated the automated Merlin MICRONAUT system for rapid direct microtiter broth antimicrobial susceptibility testing (AST) of gram-positive cocci and gram-negative bacilli from BACTEC 9240 bottles with positive blood cultures in comparison to the standard method for the Merlin MICRONAUT system. This prospective study was conducted under routine working conditions during a 9-month period. Altogether, 504 isolates from 409 patients and 11,819 organism-antibiotic combinations were evaluated for comparison of direct and standard AST methods. For gram-negative bacilli, direct and standard AST of 110 isolates was evaluated and MIC agreement was found for 98.1% of 2,637 organism-antibiotic combinations. Category (susceptible, intermediate susceptible, resistant [SIR]) agreement was found for 99.0%, with results for 0.04% of combinations showing very major errors, those for 0.2% showing major errors, and those for 0.8% showing minor errors. For gram-positive cocci, 373 isolates were evaluated and MIC agreement was found for 95.6% of 8,951 organism-antibiotic combinations. SIR agreement was found for 98.8%, with results for 0.3% of combinations showing very major errors, those for 0.4% showing major errors, and those for 0.5% showing minor errors. Although the number of tested isolates was limited (n = 33), direct AST of streptococci was performed for the first time, yielding promising results with SIR agreement for 98.6% of 363 organism-antibiotic combinations. In conclusion, direct AST of gram-negative bacilli and gram-positive cocci from positive blood cultures with the MICRONAUT system is a reliable technique that allows for the omission of repeat testing of subcultured isolates. Thereby, it reduces the time to results of blood culture testing and may have a positive impact on patient care.
机译：血流感染是危及生命的疾病，需要及时开始适当的抗微生物治疗。与Merlin MICRONAUT系统的标准方法相比，我们评估了自动Merlin MICRONAUT系统对血液培养呈阳性的BACTEC 9240瓶中革兰氏阳性球菌和革兰氏阴性杆菌进行快速直接微量滴定液药敏试验（AST）的能力。这项前瞻性研究是在9个月的常规工作条件下进行的。总共评估了409例患者的504种分离物和11,819种生物体-抗生素组合，以比较直接和标准AST方法。对于革兰氏阴性杆菌，评估了110株分离株的直接和标准AST，并且对2637种生物体-抗生素组合中的98.1％发现了MIC一致性。发现类别（易感，中等易感，抗药性[SIR]）一致性为99.0％，其中0.04％的组合结果显示非常大的错误，0.2％的结果显示有大错误，0.8％的结果显示有小错误。对于革兰氏阳性球菌，评估了373株分离物，并且在8,951种生物体-抗生素组合中发现95.6％的MIC符合性。 SIR一致性为98.8％，结果0.3％的组合显示非常大的错误，0.4％的组合显示大错误，0.5％的组合显示小错误。尽管受检菌株的数量有限（ n = 33），但还是首次对链球菌进行了直接AST，在363种生物体-抗生素组合中，有98.6％的结果通过SIR协议获得了令人满意的结果。总之，使用MICRONAUT系统对阳性血液培养物中的革兰氏阴性菌和革兰氏阳性球菌进行直接AST是一项可靠的技术，可以省去对传代培养菌株的重复检测。因此，它减少了获得血培养测试结果的时间，并且可能对患者护理产生积极影响。

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