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Comparison of Rapid and Routine Methods of Identification and Antibiotic Susceptibility Testing of Microorganisms from Blood Culture Bottles

SADIK AKGUN
SADIK AKGUN
 oraz 
HAKAN SEZGIN SAYINER
HAKAN SEZGIN SAYINER
   | 15 maj 2020
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Article Category: original-paper
Data publikacji: 15 maj 2020
Zakres stron: 165 - 176
Otrzymano: 13 lut 2020
Przyjęty: 29 mar 2020
DOI: https://doi.org/10.33073/pjm-2020-019
Słowa kluczowe
© 2020 Sadik Akgun et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

Microscopic appearance of Gram-positive bacteria after Gram staining with the routine method at a magnification of 1000×.
Microscopic appearance of Gram-positive bacteria after Gram staining with the routine method at a magnification of 1000×.

Fig. 2.

Microscopic appearance of Gram-positive bacteria after Gram staining with the rapid method at a magnification of 1000×.
Microscopic appearance of Gram-positive bacteria after Gram staining with the rapid method at a magnification of 1000×.

Fig. 3.

Microscopic appearance of Gram-negative bacteria after Gram staining with the routine method at a magnification of 1000×.
Microscopic appearance of Gram-negative bacteria after Gram staining with the routine method at a magnification of 1000×.

Fig. 4.

Microscopic appearance of Gram-negative bacteria after Gram staining with the rapid method at a magnification of 1000×.
Microscopic appearance of Gram-negative bacteria after Gram staining with the rapid method at a magnification of 1000×.

Distribution of bacteria identified by both methods at the genus and species level.

Rapid method n (%) Routine method n (%)
Gram-positive bacteria (total) 116 Gram-positive bacteria (total) 116
Staphylococcus aureus   7 (6.0) Staphylococcus aureus   8 (6.9)
MRSA: 2, MSSA: 5 MRSA: 3, MSSA: 5
Coagulase-negative Staphylococci 71 (61.2)    Coagulase-negative Staphylococci
Staphylococcus epidermidis: 45 Staphylococcus epidermidis: 48 76 (65.5)
Staphylococcus hominis: 16 Staphylococcus hominis: 18
Staphylococcusschleiferi: 4 Staphylococcusschleiferi: 4
Staphylococcus haemolyticus: 2 Staphylococcus haemolyticus: 2
Staphylococcus capitis: 2 Staphylococcus capitis: 2
Staphylococcus warneri: 2 Staphylococcus warneri: 2
Enterococci 20 (17.2)    Enterococci 20 (17.2)
Enterococcus faecalis: 18 Enterococcus faecalis: 18
Enterococcus faecium: 2   3 (2.6) Enterococcus faecium: 2   2 (1.8)
Arcanobacterium haemolyticum   3 (2.6) Arcanobacterium haemolyticum   2 (1.8)
Bacillus cereus/subtilis   2 (1.8) Bacillus subtilis   2 (1.8)
Dermacoccus nishinomiyaensis   4 (3.5) Dermacoccus nishinomiyaensis   2 (1.8)
Micrococcus luteus/lylae   3 (2.6) Micrococcus luteus/lylae   2 (1.8)
Corynebacterium amycolatum   3 (2.6) Corynebacterium amycolatum   2 (1.8)
Corynebacterium jeikeium Corynebacterium jeikeium
Gram-negative bacteria (total) 30    Gram-negative bacteria (total) 30
Escherichia coli 15 (50) Escherichia coli 15 (50)
Pseudomonas aeruginosa   5 (16.7) Pseudomonas aeruginosa   5 (16.7)
Klebsiella pneumoniae   5 (16.7) Klebsiella pneumoniae   5 (16.7)
Stenotrophomonas maltophilia   3 (10.0) Stenotrophomonas maltophilia   3 (10.0)
Acinetobacter baumannii   2 (6.7) Acinetobacter baumannii   2 (6.7)
Yeasts   4    Yeasts   4
Candida parapsilosis   2 (50) Candida parapsilosis   2 (50)
Candida tropicalis   2 (50) Candida tropicalis   2 (50)

Categorical distribution of discrepancies in the antibiotic susceptibility results of the rapid method compared to the routine method.

Antibiotics Agreementn (%) mEsn (%) MEsn (%) VMEsn (%) Totaln
Amikacin     30 (100)     30
Ampicillin     94 (100)     94
Amoxicillin/Clavulanic acid 114 (100)   114
Aztreonam     26 (86.7)   1 (3.3)   3 (10)     30
Cefepime 24 (80)   6 (20)     30
Cefoxitin   85 (98.8)   1 (1.2)     86
Ceftazidime   30 (100)     30
Ceftriaxone   30 (100)     30
Ciprofloxacin 108 (87.1) 10 (8.1)   6 (4.8)   124
Colistin   30 (100)     30
Clindamycin     93 (98.9)   1 (1.1)     94
Daptomycin     88 (93.6)   6 (6.4)     94
Ertapenem   30 (100)     30
Erythromycin   94 (100)     94
Fusidic acid     85 (98.8)   1 (1.2)     86
Gentamicin 123 (99.2)   1 (0.8)   124
Imipenem   30 (100)     30
Meropenem   30 (100)     30
Linezolid   94 (100)     94
Oxacillin   94 (100)     94
Piperacillin/Tazobactam     22 (73.3)   8 (26.7)     30
Rifampin   94 (100)     94
Teicoplanin   94 (100)     94
Tetracycline   86 (100)     86
Tigecycline     92 (97.9)   2 (2.1)     94
TMP/SX 120 (96.8)   3 (2.4)   1 (0.8)   124
Vancomycin   94 (100)     94
Total 1934 (97.4) 33 (1.7) 1 (0.1) 16 (0.8) 1984

Distribution of microorganisms detected by Gram staining after centrifugation according to the rapid method procedure.

Gram-staining result n (%)
Gram-positive cocci 107 (70.4)
Gram-negative bacilli   30 (19.7)
Gram-positive bacilli     9 (5.3)
Gram-positive cocci + Gram-negative bacilli     2 (1.3)
Yeast (Candida spp.)     4 (2.6)
Total number of samples 152 (100)

Analysis of the compatibility between the identification results of the rapid method when compared with the MALDI-TOF MS.

Bacteria Full consistencyn (%) Misidentifiedn (%) Not identifiedn (%)
Gram-positive bacteria 104 (89.7)         12 (10.3) 0
Gram-negative bacteria   30 (100) 0 0
Yeasts     4 (100) 0 0
Total 138 (92)    12 (8) 0

Distribution of the resistance profiles for Gram-positive and Gram-negative bacteria as a result of the antibiotic susceptibility testing when both methods were applied.

Antibiotics The rapid method, n (%) The routine method, n (%)
S I R S I R
Amikacin     28 (93.3) – 2 (6.7)     28 (93.3) – 2 (6.7)
Ampicillin     18 (19.1) – 76 (80.9)     18 (19.1) – 76 (80.9)
Amoxicillin/Clavulanic acid     18 (15.8) – 96 (84.2)     18 (15.8) – 96 (84.2)
Aztreonam  18 (60) 1 (3.3) 11 (36.7)  15 (50) – 15 (50)    
Cefepime     20 (66.7) – 10 (33.3)     14 (46.7) – 16 (53.3)  
Cefoxitin – 36 (41.9) 50 (58.1) – 35 (40.7) 51 (59.3) 
Ceftazidime     10 (33.3) 10 (33.3) 10 (33.3)     10 (33.3) 10 (33.3) 10 (33.3) 
Ceftriaxone  18 (60) – 12 (40)     18 (60) – 12 (40)   
Ciprofloxacin     82 (66.1) – 42 (33.9)     66 (53.2) 10 (8.1) 48 (38.7)
Colistin    30 (100) – –    30 (100) – –
Clindamycin     50 (53.2) 1 (1.1) 43 (45.7)       51 (554.3) – 43 (45.7)
Daptomycin     71 (75.5) 23 (24.5) –     65 (69.1) 29 (30.9) –
Ertapenem     28 (93.3) – 2 (6.7)     28 (93.3) – 2 (6.7)
Erythromycin     14 (14.9) – 80 (85.1)     14 (14.9) – 80 (85.1)
Fusidic acid     35 (40.7) – 51 (59.3)     36 (41.9) – 50 (58.1)
Gentamicin     66 (53.2) – 58 (46.8)     66 (53.2) 1 (0.8) 57 (50)
Imipenem     28 (93.3) – 2 (6.7)     28 (93.3) – 2 (6.7)
Meropenem     28 (93.3) – 2 (6.7)     28 (93.3) – 2 (6.7)
Linezolid     94 (100) – –     94 (100) – –
Oxacillin     12 (12.8) – 82 (87.2)     12 (12.8) – 82 (87.2)
Piperacillin/Tazobactam     10 (33.3) 10 (33.3)   10 (33.3)     16 (53.3) 2 (6.7) 12 (40)   
Rifampin   62 (66) – 32 (34)     62 (66) – 32 (34)   
Teicoplanin     94 (100) – –     94 (100) – –
Tetracycline     35 (40.7) – 51 (59.3)     35 (40.7) – 51 (59.3)
Tigecycline     84 (89.4) 8 (8.5) 2 (2.1)        86 (91.5) 6 (6.4) 2 (2.1)   
TMP/SX     55 (44.4) – 69 (55.6)     51 (41.1) 3 (2.4) 70 (56.5)
Vancomycin    94(100) – –    94 (100) – –
Total 1102 (55.5) 89 (4.5) 793 (40) 1077 (54.3) 96 (4.8) 811 (40.9)

Distribution of the identified species according to MALDI-TOF MS results when working with both methods.

Organisms MALDI-TOFBiotyper scores< 1.7; 1.7–2.0; ≥ 2n n n Total Rapid methodn Routine methodn
Gram-positive bacteria 116 116 116
Staphylococcus aureus 0 0 8 8     7     8
Staphylococcus epidermidis 0 12 36 48   45   48
Staphylococcus hominis 0 2 16 18   16   18
Staphylococcusschleiferi 0 0 4 4     4     4
Staphylococcus haemolyticus 0 0 2 2     2     2
Staphylococcus capitis 0 0 2 2     2     2
Staphylococcus warneri 0 0 2 2     2     2
Enterococcus faecalis 0 0 18 18   18   18
Enterococcus faecium 0 0 2 2     2     2
Arcanobacterium haemolyticum 0 1 1 2     3     2
Bacillus cereus/subtilis 0 0 0 0     1     0
Bacillus subtilis 0 0 2 2     2     2
Dermacoccus nishinomiyaensis 0 0 2 2     2     2
Micrococcus luteus/lylae 0 1 1 2     4     2
Corynebacterium amycolatum 0 1 1 2     3     2
Corynebacterium jeikeium 0 1 1 2     3     2
Gram-negative bacteria 30    30    30
Escherichia coli 0 0 15 15   15   15
Pseudomonas aeruginosa 0 1 4 5     5     5
Klebsiella pneumoniae 0 0 5 5     5     5
Stenotrophomonas maltophilia 0 0 3 3     3     3
Acinetobacter baumannii 0 0 2 2     2     2
Yeasts 4      4      4
Candida parapsilosis 0 0 2 2     2     2
Candida tropicalis 0 0 2 2     2
Total 0 19 131 150 150 150
eISSN:
2544-4646
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Life Sciences, Microbiology and Virology
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