Bacteriuria and phenotypic antimicrobial susceptibility testing in 45 min by point-of-care Sysmex PA-100 System: first clinical evaluation
Por:
Alonso-Tarrés, C, Moreno, CB, Navarro, F, Habison, AC, Gonzàlez-Bertran, E, Blanco, F, Borràs, J, Garrigó, M, Saker, J
Publicada:
1 ago 2024
Ahead of Print:
1 jun 2024
Resumen:
Purpose This study compared the results of the new Sysmex PA-100 AST System, a point-of-care analyser, with routine microbiology for the detection of urinary tract infections (UTI) and performance of antimicrobial susceptibility tests (AST) directly from urine.Methods Native urine samples from 278 female patients with suspected uncomplicated UTI were tested in the Sysmex PA-100 and with reference methods of routine microbiology: urine culture for bacteriuria and disc diffusion for AST.Results The analyser delivered bacteriuria results in 15 min and AST results within 45 min. Sensitivity and specificity for detection of microbiologically confirmed bacteriuria were 84.0% (89/106; 95% CI: 75.6-90.4%) and 99.4% (155/156; 95% CI: 96.5-100%), respectively, for bacterial species within the analyser specifications. These are Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus, which are common species causing uncomplicated UTI. Overall categorical agreement (OCA) for AST results for the five antimicrobials tested in the Sysmex PA-100 (amoxicillin/clavulanic acid, ciprofloxacin, fosfomycin, nitrofurantoin and trimethoprim) ranged from 85.4% (70/82; 95%CI: 75.9-92.2%) for ciprofloxacin to 96.4% (81/84; 95% CI: 89.9-99.3%) for trimethoprim. The Sysmex PA-100 provided an optimal treatment recommendation in 218/278 cases (78.4%), against 162/278 (58.3%) of clinical decisions.Conclusion This first clinical evaluation of the Sysmex PA-100 in a near-patient setting demonstrated that the analyser delivers phenotypic AST results within 45 min, which could enable rapid initiation of the correct targeted treatment with no further adjustment needed. The Sysmex PA-100 has the potential to significantly reduce ineffective or unnecessary antibiotic prescription in patients with UTI symptoms.
Filiaciones:
Alonso-Tarrés, C:
Microbiol Lab, Fundacio Puigvert, C Cartagena 340-350, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Cerdanyola Del Valles, Barcelona, Spain
Moreno, CB:
Microbiol Lab, Fundacio Puigvert, C Cartagena 340-350, Barcelona, Spain
Navarro, F:
Univ Autonoma Barcelona, Dept Genet & Microbiol, Cerdanyola Del Valles, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Lab, Barcelona, Spain
Habison, AC:
New Business Dev Dept, Sysmex Europe SE, Norderstedt, Germany
Gonzàlez-Bertran, E:
Microbiol Lab, Fundacio Puigvert, C Cartagena 340-350, Barcelona, Spain
Blanco, F:
Primary Care Dept, Sysmex Europe SE, Norderstedt, Germany
Borràs, J:
Emergency Unit, Fundacio Puigvert, Barcelona, Spain
Garrigó, M:
Univ Autonoma Barcelona, Dept Genet & Microbiol, Cerdanyola Del Valles, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Lab, Barcelona, Spain
Saker, J:
Med Sci Dept, Sysmex Europe SE, Norderstedt, Germany
hybrid
|