Wed, Apr 9, 2025
Volume 17, Issue 3 (May-Jun 2023)
mljgoums 2023, 17(3): 8-14 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Baba S K, Jan A, lone M S, kakru D K, Fomda B A, Bashir G et al . Early Detection of Antibiotic Resistance in Positive Blood Cultures: A Study from a Tertiary Care Center in India. mljgoums 2023; 17 (3) :8-14
URL: http://mlj.goums.ac.ir/article-1-1504-en.html
URL: http://mlj.goums.ac.ir/article-1-1504-en.html
Sadaf Khursheed Baba1 
, Abiroo Jan2 
, Mohd Suhail Lone3 , Dalip k Kakru4 , Bashir Ahmad Fomda5 , Gulnaz Bashir5 , Nadeem ahmad Bhat1
, Abiroo Jan2 , Mohd Suhail Lone3 , Dalip k Kakru4 , Bashir Ahmad Fomda5 , Gulnaz Bashir5 , Nadeem ahmad Bhat1
1- Department of Microbiology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
2- Department of Microbiology, Government Medical College, Anantnag, India ,abroo_naqash@yahoo.com
3- Pediatric Microbiology GMC Srinagar, India
4- Microbiology SMSR, Sharda University Knowledge Park 3, Greater Noida, India
5- Department of Microbiology Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
2- Department of Microbiology, Government Medical College, Anantnag, India ,
3- Pediatric Microbiology GMC Srinagar, India
4- Microbiology SMSR, Sharda University Knowledge Park 3, Greater Noida, India
5- Department of Microbiology Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
Abstract: (2242 Views)
Background and objectives: Conventional culture and sensitivity methods take around 48 hours to generate antibiotic sensitivity results after a blood culture is flagged as positive by automated systems. However, it is imperative to initiate early targeted antibiotic therapy for effective management of sepsis and to reduce morbidity, mortality, and cost of treatment. This study aimed to evaluate the direct sensitivity test (DST) as a potential tool to obtain quicker antibiotic susceptibility results from positive BacT/ALERT blood culture vials and the VITEK-2 system (the reference method).
Methods: Blood culture bottles flagged as positive by BacT/ALERT were Gram-stained. Cultures with polymicrobial growth were excluded from the study. The isolates were then simultaneously cultured and processed for the DST using the disk diffusion method. Agreements or errors were interpreted according to the Clinical and Laboratory Standards Institute’s guidelines.
Results: Among 76 Gram-positive isolates, we observed 99.2% essential agreement between the DST and AST. The rate of minor and major errors was 4.04% and 1.18%, respectively. Among 75 Gram-negative isolates, we observed 98.99% essential agreement between the DST and AST. The rate of minor and major errors was 4% and 2%, respectively. No very major error was seen in either Gram-negative or -positive isolates.
Conclusions: The DST results are available earlier than the AST results, which can ultimately help in the early initiation of targeted antibiotic therapy.
Methods: Blood culture bottles flagged as positive by BacT/ALERT were Gram-stained. Cultures with polymicrobial growth were excluded from the study. The isolates were then simultaneously cultured and processed for the DST using the disk diffusion method. Agreements or errors were interpreted according to the Clinical and Laboratory Standards Institute’s guidelines.
Results: Among 76 Gram-positive isolates, we observed 99.2% essential agreement between the DST and AST. The rate of minor and major errors was 4.04% and 1.18%, respectively. Among 75 Gram-negative isolates, we observed 98.99% essential agreement between the DST and AST. The rate of minor and major errors was 4% and 2%, respectively. No very major error was seen in either Gram-negative or -positive isolates.
Conclusions: The DST results are available earlier than the AST results, which can ultimately help in the early initiation of targeted antibiotic therapy.
Research Article: Original Paper |
Subject:
bacteriology
Received: 2022/04/19 | Accepted: 2023/02/27 | Published: 2023/03/14 | ePublished: 2023/03/14
Received: 2022/04/19 | Accepted: 2023/02/27 | Published: 2023/03/14 | ePublished: 2023/03/14
References
1. Henriquez-Camacho C, Losa J. Biomarkers for sepsis. Biomed Res Int. 2014;2014:547818. [View at Publisher] [DOI:10.1155/2014/547818] [PubMed] [Google Scholar]
2. Evans L, Rhodes A, Alhazzani W. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Intensive care Med. 2021; 47: 1181-1247. [View at Publisher] [DOI:10.1007/s00134-021-06506-y]
3. Baron EJ, Weinstein MP, Dume WM, Yagupsky P, Welch DF, Wilson DM, et al. Blood Cultures IV. Washington: American Society of Microbiology; 2005.
4. Gherardi G, Angeletti S, Panitti M, Pompilio A, Di Bonaventura G, Crea F, et al. Comparative evaluation of the Vitek-2 Compact and Phoenix systems for rapid identification and antibiotic susceptibility testing directly from blood cultures of Gram-negative and Gram-positive isolates. DiagnMicrobiol Infect Dis. 2012; 72: 20-31. [View at Publisher] [DOI:10.1016/j.diagmicrobio.2011.09.015] [PubMed] [Google Scholar]
5. Cercenado E, Cercenado S, Marín M, Rico MV, Vicente T, Bouza E. Evaluation of direct E-test on lower respiratory tract samples: a rapid and accurate procedure for antimicrobial susceptibility testing. DiagnMicrobiolInfe Dis. 2007; 58: 211-216. [View at Publisher] [DOI:10.1016/j.diagmicrobio.2006.12.021] [PubMed] [Google Scholar]
6. Johnson JR, Tiu FS, Stamm WE. Direct antimicrobial susceptibility testing for acute urinary tract infections in women. J Clin Microbiol. 1995; 33: 2316-2323. [View at Publisher] [DOI:10.1128/jcm.33.9.2316-2323.1995] [PubMed] [Google Scholar]
7. Doern GV, Vautour R, Gaudet M, Levy B. Clinical impact of rapid in vitro susceptibility testing and bacterial identification. J Clin Microbiol 1994; 32: 1757-62. [View at Publisher] [DOI:10.1128/jcm.32.7.1757-1762.1994] [PubMed] [Google Scholar]
8. Barenfanger J, Drake C, Kacich G. Clinical and financial benefits of rapid bacterial identification and antimicrobial susceptibility testing. J Clin Microbiol 1999; 37: 1415-8. [View at Publisher] [DOI:10.1128/JCM.37.5.1415-1418.1999] [PubMed] [Google Scholar]
9. Andrews JM. BSAC Working Party on Susceptibility Testing. BSAC standardized disc susceptibility testing method (version 4). J Antimicrob Chemother. 2005;56(1): 60-76. [View at Publisher] [DOI:10.1093/jac/dkl277] [PubMed] [Google Scholar]
10. Clinical and laboratory standard institute 2014.Performance standards for antimicrobial susceptibility testing; 24th informational supplement. CLSI document M100-S24. Wyneg PA. [View at Publisher]
11. Goel G, Das D, Mukherjee S, Bose S, Das K, Mahato R, Bhattacharya S. A method for early detection of antibiotic resistance in positive blood cultures: Experience from an oncology centre in eastern India. Indian J Med Microbiol. 2015; 33(5): 53-58. [View at Publisher] [DOI:10.4103/0255-0857.150883] [PubMed] [Google Scholar]
12. Prakash Simkhada, Shiva Raj KC, Santosh Lamichhane, Surya Subedi, Upendra Thapa Shrestha. Bacteriological Profile and Antibiotic Susceptibility Pattern of Blood Culture Isolates from Patients Visiting Tertiary Care Hospital. Global Journal of Medical Research: Microbiology and Pathology. 2016; 16(1): 24-31. [View at Publisher] [Google Scholar]
13. Harbarth S, Garbino J, Pugin J, Romand JA, Lew D, Pittet D. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. Am J Med 2003; 115: 529-35. [View at Publisher] [DOI:10.1016/j.amjmed.2003.07.005] [PubMed] [Google Scholar]
14. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. New Engl J Med. 2003; 348: 1546-54. [View at Publisher] [DOI:10.1056/NEJMoa022139] [PubMed] [Google Scholar]
15. Kimberle C. Chapin and Michael C. Musgnug. Direct Susceptibility Testing of Positive Blood Cultures by Using Sensititre Broth Microdilution Plates. J Clin Microbiol. 2003; 41(10): 4751-4754. [View at Publisher] [DOI:10.1128/JCM.41.10.4751-4754.2003] [PubMed] [Google Scholar]
16. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004; 39(3): 309-17. [View at Publisher] [DOI:10.1086/421946] [PubMed] [Google Scholar]
17. de Cueto M, Ceballos E, Martinez-Martinez L, Perea EJ, Pascual A. Use of positive blood cultures for direct identification and susceptibility testing with the vitek 2 system. J Clin Microbiol. 2004; 42(8): 3734-8. [View at Publisher] [DOI:10.1128/JCM.42.8.3734-3738.2004] [PubMed] [Google Scholar]
18. Jyoti P, Sonawane N. Kamath, Keertana Shetty, Rita Swaminathan. Bacteriological Profile and Antimicrobial Susceptibility of Blood CultureIsolates from Tertiary Care Hospital, Navi Mumbai. Journal of Medical Science and Clinical Research. 2016; 4(10):13116-13124. [View at Publisher] [DOI:10.18535/jmscr/v4i10.35]
19. Andrea Zappavigna, EnricaCavatorta, Rossana Chiarabini, Roberta Schiavo,DanielaPadrini, Camilla Reboli, Massimo Confalonieri. Direct antimicrobial susceptibility testing of Gram-negative bacteria from positive blood cultures.Microbiologia Medica 2013;28 (3). [DOI:10.4081/mm.2013.3272]
20. RahilaYakoob, Gopalkrishna Bhat K. Comparision of Direct Antibiotic Susceptibility Testing with Standard Testing in Blood Culture. J Pure Appl Microbiol. 2018; 12(4): 2289-2296. [View at Publisher] [DOI:10.22207/JPAM.12.4.70] [Google Scholar]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Enamad
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.