Saponin promotes rapid identification and antimicrobial susceptibility profiling of Gram-positive and Gram-negative bacteria in blood cultures with the Vitek 2 system

Eur J Clin Microbiol Infect Dis. 2013 Apr;32(4):493-502. doi: 10.1007/s10096-012-1762-z. Epub 2012 Nov 2.

Abstract

The rapid identification and antimicrobial susceptibility testing (AST) of bacteria in clinical blood cultures is crucial to optimise antimicrobial therapy. A previous study involving small sample numbers revealed that the addition of saponin to blood cultures, further referred to as the new method, shortened considerably the turn-around time for the identification and AST of Gram-positive cocci as compared to the current method involving an overnight subculture. Here, we extend previous results and compare the identification and AST of blood cultures containing Gram-negative bacilli by the new and current methods. The identification and AST of 121 Gram-positive and 109 Gram-negative bacteria in clinical monomicrobial blood cultures by the new and current methods and, in the case of Gram-negative bacilli, by direct (no additions) inoculation into an automated system (rapid method) was assessed using the Vitek 2 system. Discrepancies between the results obtained with the different methods were solved by manual methods. The new method correctly identified 88 % of Gram-positive and 98 % of Gram-negative bacteria, and the rapid method correctly identified 94 % of Gram-negative bacteria. The AST for all antimicrobials by the new method were concordant with the current method for 55 % and correct for an additional 9 % of Gram-positive bacteria, and concordant with the current method for 62 % and correct for an additional 21 % of Gram-negative bacilli. The AST by the rapid method was concordant with the current method for 62 % and correct for an additional 12 % of Gram-negative bacilli. Together, saponin-treated monomicrobial blood cultures allow rapid and reliable identification and AST of Gram-positive and Gram-negative bacteria.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Bacteremia / diagnosis*
  • Bacteremia / microbiology
  • Bacterial Typing Techniques / methods*
  • Gram-Negative Bacteria / classification
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Positive Bacteria
  • Humans
  • Microbial Sensitivity Tests / methods
  • Saponins*
  • Specimen Handling / methods*
  • Time Factors

Substances

  • Saponins