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快速色度测定抗微生物易感性直接来自对格拉姆阴性细菌的阳性血液培养

Prakash C Khanal¹, Joseph C Richardson¹, Katherine G Richardson¹

¹School of Chemistry & Biochemistry and Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia, USA.

Microbiology spectrum

|September 19, 2025

概括

一种新的自动化测定方法 (ChroMIC) 从阳性血液培养直接快速确定抗微生物敏感性. 这种方法显著加快了血液感染 (BSI) 的治疗决策,改善了患者的治疗结果并降低了医疗保健成本.

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
诊断试验的发展.

背景情况:

由于抗菌素耐药性 (AMR) 的上升,血流感染 (BSI) 带来了重大治疗挑战.
目前的表型抗微生物敏感性测试 (AST) 方法通常是缓慢的,延迟了对败血症的关键治疗调整.
快速的AST对于有效管理BSI和改善患者预后至关重要.

研究的目的:

开发和评估一个自动化,实时的色度测试 (ChroMIC) 来从阳性血液培养物中直接表型确定最小抑制度 (MIC).
为了比较ChroMIC与标准临床方法 (VITEK 2和微稀释) 对阴性细菌的性能.
评估 ChroMIC 对临床决策和患者护理时间表的潜在影响.

主要方法:

开发一种自动化的实时色度测试 (ChroMIC) 来直接从阳性血液培养物中确定MIC.
通过使用ChromiC,VITEK 2和微稀释 (BMD) 来分析83名患者血液培养中的格兰阴性细菌.
与VITEK 2和BMD MIC相比,ChromiC MIC的比较,评估分类和基本一致性,以及错误率.

主要成果:

克罗米克提供直接来自血液培养的MIC,而不需要长达18小时的生长和隔离步骤.
试验在实验启动7小时和生长检测4小时内达到了>90%的绝对和基本一致.
克罗米克显示出与VITEK 2相比的或更高的错误率 (包括非常严重的错误),这需要额外的~18小时的亚培养延迟.
追溯分析表明,ChroMIC可能会促进更早的治疗决策,平均节省了抗微生物升级的35小时和降低升级的43小时.

结论:

克罗米克测定提供了一个快速而准确的方法,直接从阳性血液培养物中检测表型AST.
这种创新方法有可能显著缩短BSI最佳抗微生物治疗的时间.
实施ChroMIC可能会改善患者的治疗结果,减少住院时间,降低医疗费用.

关键词:

血液感染血液感染颜色测量仪的颜色测量方法诊断诊断诊断诊断诊断机器学习是机器学习.光学仪器仪器仪器仪器仪器仪器仪器仪器仪器仪器仪器仪器仪器易感性测试易感性测试易感性测试

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