散射光集成收集器技术用于快速血液培养敏感性检测的研究。

L White, R Hammond, R J Shorten, J P Derrick
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摘要

引言败血症发病率不断上升,革兰氏阴性菌在血流感染中占很大比例。为有效管理这些患者,需要在进行诊断检查的同时快速使用抗生素。目前的诊断方法需要 48 小时才能得出最终报告,因此需要快速诊断方法。本研究调查了一种新型抗生素敏感性方法--散射光积分收集器(SLIC),并结合使用基质辅助激光解吸/电离飞行时间(MALDI-TOF)技术的快速鉴定方法,以确定能否在血培养阳性报告发出后 4 小时内提供准确的鉴定和药敏结果。使用 MALDI-TOF Biotyper Sepsityper 直接从血液中进行鉴定,并使用 SLIC 仪器进行药敏试验。此外,还使用所在实验室目前使用的标准工作流程对所有微生物进行了检测。确定了分类一致性(CA)、主要误差(MaE)和极主要误差(VME)。SLIC得出的药敏结果CA为71.9%,MaE为30.6%,VME为17.5%。与当前方法相比,得出最终结果的时间中位数差异为 44.14 (43 : 05-45 : 15) h。我们的结论是,与目前的标准方法相比,SLIC 无法持续提供足够准确的抗生素药敏结果。
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An investigation of scattered light integrating collector technology for rapid blood culture sensitivity testing.

Introduction. Sepsis rates are increasing, with Gram-negative organisms representing a large proportion of bloodstream infections. Rapid antibiotic administration, alongside diagnostic investigations, is required for the effective management of these patients.Gap statement. Current diagnostics take ~48 h for a final report; therefore, rapid diagnostics are required.Aim. This study investigated a novel antibiotic sensitivity method, the scattered light integrating collector (SLIC), combined with a rapid identification method using matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) technology to determine if an accurate identification and susceptibility result can be provided within 4 h of a positive blood culture report.Methodology. A total of 47 blood cultures containing Gram-negative bacteria from 46 patients were processed using the MALDI-TOF Biotyper Sepsityper for identification directly from the blood and the SLIC instrument for susceptibility testing. All organisms were also tested using the current standard workflow used in the host laboratory. Categorical agreement (CA), major errors (MaEs) and very major errors (VMEs) were determined.Results. SLIC produced susceptibility results with a 71.9% CA, 30.6% MaE and 17.5% VME. The median difference in time to the final result was 44.14 (43 : 05-45 : 15) h earlier compared to the current method.Conclusion. We conclude that SLIC was unable to consistently provide sufficiently accurate antibiotic susceptibility results compared to the current standard method.

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