Evaluation of FASTinov for rapid antimicrobial susceptibility testing in Pseudomonas aeruginosa
Carmen Cintora-Mairal1,2, José Manuel Ortiz de la Rosa3,4,5, Cidália Pina-Vaz6,7
1Unidad de Enfermedades Infecciosas, Microbiología y Parasitología Clínica, Hospital Universitario Virgen del Rocío, Seville, Spain.
Abstract:
Pseudomonas aeruginosa is a critical priority pathogen due to its high resistance rates and limited treatment options. Rapid antimicrobial susceptibility testing (rAST) is essential to optimize therapy, particularly because resistance mechanisms in P. aeruginosa often arise from adaptive genetic expression rather than specific resistance genes. FASTinov, a flow cytometry-based rAST system, was developed to address this challenge by providing phenotypic susceptibility results within hours. In this study, we assessed FASTinov's performance for rapid antimicrobial susceptibility testing (rAST) in 100 P. aeruginosa strains, using broth microdilution as the reference method. For clinical relevance, we also included the MicroScan WalkAway system as a comparator. FASTinov demonstrated a categorical agreement of 99% across the tested antibiotics, with particularly strong agreement for cephalosporins. Notably, FASTinov significantly reduced the time to results, delivering susceptibility data in an average of 3.15 h (CI 95% 3.13-3.17), compared to 28.88 h (CI 95% 20.71-37.04) for standard methods. Additionally, the system exhibited lower rates of major and very major errors compared to MicroScan, further reinforcing its reliability. These findings highlight FASTinov as a promising rAST system capable of providing rapid and accurate susceptibility profiles directly from bacterial colonies. Further research is warranted to evaluate its clinical impact on patient outcomes and cost-effectiveness.
Insights
FASTinov, a novel flow cytometry system, provides rapid antimicrobial susceptibility testing for Pseudomonas aeruginosa. This technology delivers accurate results within hours, significantly outperforming standard methods and offering a promising solution for optimizing antibiotic therapy.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Pseudomonas aeruginosa is a priority pathogen with high resistance rates and limited treatment options.
- Resistance mechanisms in P. aeruginosa often stem from adaptive genetic expression, necessitating phenotypic testing.
- Rapid antimicrobial susceptibility testing (rAST) is crucial for timely and effective therapeutic optimization.
Purpose of the Study:
- To evaluate the performance of FASTinov, a flow cytometry-based rAST system, for P. aeruginosa.
- To compare FASTinov's accuracy and speed against standard methods (broth microdilution and MicroScan WalkAway).
Main Methods:
- FASTinov system utilizing flow cytometry was tested on 100 P. aeruginosa strains.
- Broth microdilution served as the reference method for susceptibility testing.
- MicroScan WalkAway was used as a clinical comparator.
Main Results:
- FASTinov achieved 99% categorical agreement across tested antibiotics, with high accuracy for cephalosporins.
- The system provided results significantly faster, averaging 3.15 hours compared to standard methods (28.88 hours).
- FASTinov demonstrated lower rates of major and very major errors than the MicroScan system.
Conclusions:
- FASTinov is a reliable and rapid phenotypic susceptibility testing system for P. aeruginosa directly from colonies.
- The system offers a significant time advantage over conventional methods for guiding antimicrobial therapy.
- Further studies are recommended to assess FASTinov's clinical utility and cost-effectiveness.
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