Evaluation of the Accelerate Pheno System for Identification of Acinetobacter Clinical Isolates and Minocycline Susceptibility Testing

J Clin Microbiol. 2019 Feb 27;57(3):e01711-18. doi: 10.1128/JCM.01711-18. Print 2019 Mar.

Abstract

The Accelerate Pheno system (AXDX) is a rapid phenotypic bacterial identification and susceptibility testing system which is approved for use with positive blood cultures. Acinetobacter baumannii is a nosocomial pathogen for which the limited treatment options include minocycline in the case of multidrug resistance. Here, we studied the performance of A. baumannii identification and minocycline susceptibility testing by AXDX using 101 contemporary Acinetobacter sp. clinical isolates. Overall, the sensitivity for A. baumannii and A. baumannii complex identification was 100% (73/73) and 97.6% (82/84), respectively. Specificity for A. baumannii complex identification was 86.6% (13/15). The essential agreement of minocycline susceptibility results (±1 log2 MIC agreement) of AXDX MICs with reference broth microdilution was 98.0% (96/98). There were no very major errors or major errors. Overall, 24.5% (24/98) of results yielded minor errors. AXDX reliably identified A. baumannii and predicted minocycline susceptibility results, which should help guide treatment choices in a timely manner for infections where options are limited.

Keywords: fluorescence in situ hybridization; morphokinetic cellular analysis; rapid diagnostics; susceptibility testing.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter Infections / microbiology
  • Acinetobacter baumannii / classification
  • Acinetobacter baumannii / drug effects*
  • Acinetobacter baumannii / isolation & purification*
  • Anti-Bacterial Agents / pharmacology*
  • Blood Culture
  • Drug Resistance, Bacterial
  • Humans
  • In Situ Hybridization, Fluorescence
  • Microbial Sensitivity Tests / methods*
  • Microbial Sensitivity Tests / standards*
  • Minocycline / pharmacology*
  • Sensitivity and Specificity

Substances

  • Anti-Bacterial Agents
  • Minocycline