Delving into discrepancies, a single-center experience with Accelerate Pheno for gram-negative bacteremia, a rapid phenotypic susceptibility testing method
Abstract Objective: Discrepancies or inaccuracies between testing methods can create confusion or lead to clinical harm if antibiotics are inappropriately chosen. We report our clinical experience using the Accelerate Pheno™ followed by routine automated susceptibilities by the Vitek®2 for positiv...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X24004820/type/journal_article |
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| author | Zoe Freeman Weiss Dimitar Zelenkov Jon Englert Maureen Campion |
| author_facet | Zoe Freeman Weiss Dimitar Zelenkov Jon Englert Maureen Campion |
| author_sort | Zoe Freeman Weiss |
| collection | DOAJ |
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Abstract
Objective:
Discrepancies or inaccuracies between testing methods can create confusion or lead to clinical harm if antibiotics are inappropriately chosen. We report our clinical experience using the Accelerate Pheno™ followed by routine automated susceptibilities by the Vitek®2 for positive blood cultures with gram-negative rods.
Design:
This was a retrospective review of positive gram-negative blood cultures, including comparison of susceptibility testing results and impact on clinical care.
Setting:
Academic teaching hospital.
Patients (participants):
All patients admitted to the hospital with gram-negative bacteremia from January 2020 to December 2022.
Methods:
Microbiology was reviewed for discrepancies as defined by very major errors (VMEs), major errors (MEs), and minor errors (mEs). Clinical charts were reviewed for antibiotic therapy.
Results:
Positive blood cultures with gram-negative rods were included (n = 262). Between these two methods, overall essential agreement was 93.7% (2162/2304) and categorical agreement 93.5% (2159/2306). There were 147 discrepancies noted, including 6 VMEs, 25 MEs, and 116 mEs accounting for 96 patients. Antibiotic choice was changed in 8 patients due to perceived suboptimal empiric therapy based on the rapid susceptibility results.
Conclusions:
The Accelerate Pheno tended to over-call resistance compared to the Vitek®2. Few patients (8) received the incorrect antibiotic based on the Pheno result. Stewardship programs may choose to optimize their rapid antibiotic susceptibility testing reporting to help minimize confusion and guide appropriate antibiotic selection.
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| format | Article |
| id | doaj-art-ed5bd743e11044689a2e2418d2e2d2c1 |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-ed5bd743e11044689a2e2418d2e2d2c12025-01-23T07:56:08ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2024.482Delving into discrepancies, a single-center experience with Accelerate Pheno for gram-negative bacteremia, a rapid phenotypic susceptibility testing methodZoe Freeman Weiss0https://orcid.org/0000-0003-2931-3660Dimitar Zelenkov1Jon Englert2Maureen Campion3https://orcid.org/0000-0001-5167-0766Department of Pathology, Tufts Medical Center, Boston, MA, USA Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USATufts Medical Center, Department of Pharmacy, Boston, MA, USAAccelerate Diagnostics, Tucson, AZ, USADivision of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA Tufts Medical Center, Department of Pharmacy, Boston, MA, USA Abstract Objective: Discrepancies or inaccuracies between testing methods can create confusion or lead to clinical harm if antibiotics are inappropriately chosen. We report our clinical experience using the Accelerate Pheno™ followed by routine automated susceptibilities by the Vitek®2 for positive blood cultures with gram-negative rods. Design: This was a retrospective review of positive gram-negative blood cultures, including comparison of susceptibility testing results and impact on clinical care. Setting: Academic teaching hospital. Patients (participants): All patients admitted to the hospital with gram-negative bacteremia from January 2020 to December 2022. Methods: Microbiology was reviewed for discrepancies as defined by very major errors (VMEs), major errors (MEs), and minor errors (mEs). Clinical charts were reviewed for antibiotic therapy. Results: Positive blood cultures with gram-negative rods were included (n = 262). Between these two methods, overall essential agreement was 93.7% (2162/2304) and categorical agreement 93.5% (2159/2306). There were 147 discrepancies noted, including 6 VMEs, 25 MEs, and 116 mEs accounting for 96 patients. Antibiotic choice was changed in 8 patients due to perceived suboptimal empiric therapy based on the rapid susceptibility results. Conclusions: The Accelerate Pheno tended to over-call resistance compared to the Vitek®2. Few patients (8) received the incorrect antibiotic based on the Pheno result. Stewardship programs may choose to optimize their rapid antibiotic susceptibility testing reporting to help minimize confusion and guide appropriate antibiotic selection. https://www.cambridge.org/core/product/identifier/S2732494X24004820/type/journal_article |
| spellingShingle | Zoe Freeman Weiss Dimitar Zelenkov Jon Englert Maureen Campion Delving into discrepancies, a single-center experience with Accelerate Pheno for gram-negative bacteremia, a rapid phenotypic susceptibility testing method Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Delving into discrepancies, a single-center experience with Accelerate Pheno for gram-negative bacteremia, a rapid phenotypic susceptibility testing method |
| title_full | Delving into discrepancies, a single-center experience with Accelerate Pheno for gram-negative bacteremia, a rapid phenotypic susceptibility testing method |
| title_fullStr | Delving into discrepancies, a single-center experience with Accelerate Pheno for gram-negative bacteremia, a rapid phenotypic susceptibility testing method |
| title_full_unstemmed | Delving into discrepancies, a single-center experience with Accelerate Pheno for gram-negative bacteremia, a rapid phenotypic susceptibility testing method |
| title_short | Delving into discrepancies, a single-center experience with Accelerate Pheno for gram-negative bacteremia, a rapid phenotypic susceptibility testing method |
| title_sort | delving into discrepancies a single center experience with accelerate pheno for gram negative bacteremia a rapid phenotypic susceptibility testing method |
| url | https://www.cambridge.org/core/product/identifier/S2732494X24004820/type/journal_article |
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