Antibiotic treatment algorithm development based on a microarray nucleic acid assay for rapid bacterial identification and resistance determination from positive blood cultures

Jürgen Rödel; Matthias Karrasch; Birgit Edel; Sylvia Stoll; Jürgen Bohnert; Bettina Löffler; Angela Saupe; Wolfgang Pfister

doi:10.1016/j.diagmicrobio.2015.10.021

Antibiotic treatment algorithm development based on a microarray nucleic acid assay for rapid bacterial identification and resistance determination from positive blood cultures

Diagn Microbiol Infect Dis. 2016 Mar;84(3):252-7. doi: 10.1016/j.diagmicrobio.2015.10.021. Epub 2015 Nov 14.

Authors

Jürgen Rödel¹, Matthias Karrasch², Birgit Edel², Sylvia Stoll², Jürgen Bohnert², Bettina Löffler², Angela Saupe², Wolfgang Pfister²

Affiliations

¹ Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany. Electronic address: juergen.roedel@med.uni-jena.de.
² Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany.

PMID: 26712265
DOI: 10.1016/j.diagmicrobio.2015.10.021

Abstract

Rapid diagnosis of bloodstream infections remains a challenge for the early targeting of an antibiotic therapy in sepsis patients. In recent studies, the reliability of the Nanosphere Verigene Gram-positive and Gram-negative blood culture (BC-GP and BC-GN) assays for the rapid identification of bacteria and resistance genes directly from positive BCs has been demonstrated. In this work, we have developed a model to define treatment recommendations by combining Verigene test results with knowledge on local antibiotic resistance patterns of bacterial pathogens. The data of 275 positive BCs were analyzed. Two hundred sixty-three isolates (95.6%) were included in the Verigene assay panels, and 257 isolates (93.5%) were correctly identified. The agreement of the detection of resistance genes with subsequent phenotypic susceptibility testing was 100%. The hospital antibiogram was used to develop a treatment algorithm on the basis of Verigene results that may contribute to a faster patient management.

Keywords: Blood culture; Sepsis; Verigene array; antimicrobial stewardship.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Algorithms
Anti-Bacterial Agents / pharmacology*
Anti-Bacterial Agents / therapeutic use*
Bacteremia / diagnosis
Bacteremia / drug therapy*
Bacteremia / microbiology*
Drug Resistance, Bacterial*
Gram-Negative Bacteria / classification
Gram-Negative Bacteria / drug effects
Gram-Negative Bacteria / genetics
Gram-Positive Bacteria / classification
Gram-Positive Bacteria / drug effects
Gram-Positive Bacteria / genetics
Humans
Microbial Sensitivity Tests
Oligonucleotide Array Sequence Analysis / methods*
Reproducibility of Results
Sensitivity and Specificity

Substances

Anti-Bacterial Agents