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开发和评估一个直接的磁盘扩散,快速的抗微生物敏感性测试方法从血培养阳性用快速分子测试和微生物学实验室自动化测试用格拉姆阴性菌根的血液培养

Melvilí Cintrón¹, Brenden Clark¹, Edwin Miranda¹

¹Clinical Microbiology Service, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Microbiology spectrum

|May 15, 2025

概括

快速抗微生物敏感性测试 (RAST) 与分子识别 (BCID) 和实验室自动化 (MLA) 结合,为大肠杆菌和K. pneumoniae提供了早期结果. 该工作流提供关键的抗微生物敏感性数据,以快速指导患者治疗.

科学领域:

临床微生物学临床微生物学
传染性疾病传染性疾病
抗微生物耐药性抗微生物耐药性

背景情况:

从阳性血液培养 (BC) 获得的快速抗微生物敏感性测试 (RAST) 对于有效的抗微生物治疗启动至关重要.
分子血液培养识别 (BCID) 面板和微生物学实验室自动化 (MLA) 提供了提高RAST效率的机会.

研究的目的:

评估和优化一个与BCID和MLA集成的RAST工作流程,用于关键的格拉姆阴性病原体:大肠杆菌,Klebsiella肺炎和Pseudomonas aeruginosa.
根据既有方法评估自动化RAST解释的性能.

主要方法:

对大肠杆菌,肺炎或P. aeruginosa阳性的单微生物BCs使用BCID.被确定.
对阳性BC进行了自动RAST,MLA在4,6和8小时拍摄了图像.
使用EUCAST RAST断点和WASPLab Halo识别软件解释了抑制区域的测量结果;结果与自动化微薄膜稀释 (aMBD) 相比较.

主要成果:

在所有时间点对大肠杆菌和K. pneumoniae进行测试的大多数抗微生物药物中,RAST和aMBD之间的分类一致性 (CA) 超过了90%.
错误率一般较低:小错误 (<4%),重大错误 (1-6%) 和非常重大错误 (2-9%).
对于piperacillin/tazobactam和P. aeruginosa,RAST的性能低于最佳,CAS较低,错误率更高.

结论:

将BCID与自动化RAST设置和解释相结合,可及时提供E. coli和K. pneumoniae的初步抗菌敏感性结果.
评估的RAST工作流程,利用MLA和自动读取,表明在阳性BC标志后6小时内快速AST报告的潜力.
自动化抑制区测量显示,在75%的记录测量的准确度,支持在RAST.LA的MLA的实用性.

关键词:

美国大肠杆菌 (E. coli).欧卡斯特欧卡斯特克莱布西拉肺炎和 Pseudomonas aeruginosa 这两种类型的肺炎.人工智能的人工智能是人工智能.实验室自动化实验室自动化快速的抗微生物敏感性测试.

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