Clinical evaluation of the acuitas® AMR gene panel for rapid detection of bacteria and genotypic antibiotic resistance determinants

Stefan Riedel; Justin Halls; Sanjucta Dutta; Nikhil Toraskar; Jamie Lemon; Kendra Carter; Will Sinclair; Bert K Lopansri; Amanda M Styer; Donna M Wolk; G Terrance Walker

doi:10.1016/j.diagmicrobio.2021.115383

Clinical evaluation of the acuitas® AMR gene panel for rapid detection of bacteria and genotypic antibiotic resistance determinants

Diagn Microbiol Infect Dis. 2021 Aug;100(4):115383. doi: 10.1016/j.diagmicrobio.2021.115383. Epub 2021 Mar 26.

Authors

Affiliations

¹ Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: sriedel@bidmc.harvard.edu.
² Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
³ OpGen, Inc., Gaithersburg, MD, USA.
⁴ Intermountain Medical Center, Central Microbiology Laboratory, Murray, UT, USA.
⁵ Intermountain Medical Center, Central Microbiology Laboratory, Murray, UT, USA; University of Utah, Department of Internal Medicine, Salt Lake City, UT, USA.
⁶ Geisinger Health System, Diagnostic Medical Institute, Danville, PA, USA.

PMID: 33894657
DOI: 10.1016/j.diagmicrobio.2021.115383

Abstract

Urinary tract infections are leading causes of hospital admissions. Accurate and timely diagnosis is important due to increasing morbidity and mortality from antimicrobial resistance. We evaluated a polymerase chain reaction test (Acuitas AMR Gene Panel with the Acuitas Lighthouse Software) for detection of 5 common uropathogens (Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Enterococcus faecalis) and antibiotic resistance genes directly from urine for prediction of phenotypic resistance. Overall percent agreement was 97% for semiquantitative detection of uropathogens versus urine culture using a cut-off of 10⁴ colony forming units per mL urine. Overall accuracy was 91% to 93% for genotypic prediction of common antibiotic resistance harbored by E. coli, K. pneumoniae, and P. mirabilis.

Keywords: Acuitas AMR Gene Panel; Acuitas Lighthouse; Antimicrobial Resistance; Antimicrobial Susceptibility Testing; Generalized Linear Models; Polymerase Chain Reaction; Syndromic testing; Urinary Tract Infection.

Publication types

Evaluation Study

MeSH terms

Anti-Bacterial Agents / pharmacology*
Bacteria / classification
Bacteria / drug effects*
Bacteria / genetics*
Drug Resistance, Multiple, Bacterial / genetics*
Enterococcus faecalis / drug effects
Enterococcus faecalis / genetics
Genotype*
Humans
Klebsiella pneumoniae / drug effects
Klebsiella pneumoniae / genetics
Microbial Sensitivity Tests
Molecular Diagnostic Techniques / instrumentation
Molecular Diagnostic Techniques / standards*
Polymerase Chain Reaction / standards
Proteus mirabilis / drug effects
Proteus mirabilis / genetics
Pseudomonas aeruginosa / drug effects
Pseudomonas aeruginosa / genetics
Tertiary Care Centers
Urinary Tract Infections / diagnosis*
Urinary Tract Infections / microbiology
Urinary Tract Infections / urine

Substances

Anti-Bacterial Agents