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EUCAST rapid antimicrobial susceptibility testing (RAST) in blood cultures: validation in 55 European laboratories

2020; Oxford University Press; Volume: 75; Issue: 11 Linguagem: Inglês

10.1093/jac/dkaa333

1460-2091

Anna Åkerlund, Emma Jonasson, Erika Matuschek, Lena Serrander, Martin Sundqvist, Gunnar Kahlmeter, Esad Dzajic, Dennis Schrøder Hansen, harlotte Nielsen Agergaard, Anu Pätäri‐Sampo, Raija Manninen, Juha O. Grönroos, Jean‐Philippe Rasigade, Waël Salka, Pierre Boyer, Evangelia Lebessi, Nikolaos Zapaniotis, Efi Petinaki, Iris Spiliopoulou, Fevronia Kolonitsiou, Kristján Orri Helgason, Jean Brazil, Eleonora Riccobono, Giuliana Lo Cascio, Laura Maccacaro, Helge Kolstad, Torunn Sneide Haukeland, Pirkko-Liisa Kellokumpu, Andreas Fossum Mjøen, Ståle Tofteland, Berit Harbak, Susanne Hartvig Hartzen, Siri Haug Hänsgen, Karianne Wiger Gammelsrud, Unni Skolbekken, Nina Michalsen, Anita Løvås Brekken, Bodil Pedersen, Brian Guennigsman, Astrid Lia, Ann Kristin Berg, Francesco Marco, Cristina Pitart, Pilar Egea, José Luis Cortes-Cuevas, Jesús Machuca, Martin Wietzke, Magdalena Dammström, Roger Granström, Maria Corneliusson, Marita Skarstedt, Karin Frykfeldt, Carina Lindqvist Ivarsson, Adam Sergejev, Susanna Hagström, Ulrika Lidén, Johan Mölne, Hanna Ramström, Inga Fröding, Evangelos Alexandros Petropoulos, Karolina Ininbergs, Shah Jalal, A. Persson, Nina Kamenska, K. Granlund, Anna-Karin Smekal, A. W. Hill, Gunilla Rådberg, Gabriel Heyman, Lized Rodriguez, Lisa Vennberg, Gülşen­ Hazırolan, Işın Akyar, Gelmez Gülşen Altınkanat, Ayşe Nur Sarı Kaygısız, Esad Dzajic, Dennis Schrøder Hansen, harlotte Nielsen Agergaard, Anu Pätäri‐Sampo, Raija Manninen, Juha O. Grönroos, Jean‐Philippe Rasigade, Waël Salka, Pierre Boyer, Evangelia Lebessi, Nikolaos Zapaniotis, Efi Petinaki, Iris Spiliopoulou, Fevronia Kolonitsiou, Kristján Orri Helgason, Jean Brazil, Eleonora Riccobono, Giuliana Lo Cascio, Laura Maccacaro, Helge Kolstad, Torunn Sneide Haukeland, Pirkko-Liisa Kellokumpu, Andreas Fossum Mjøen, Ståle Tofteland, Berit Harbak, Susanne Hartvig Hartzen, Siri Haug Hänsgen, Karianne Wiger Gammelsrud, Unni Skolbekken, Nina Michalsen, Anita Løvås Brekken, Bodil Pedersen, Brian Guennigsman, Astrid Lia, Ann Kristin Berg, Francesco Marco, Cristina Pitart, Pilar Egea, José Luis Cortes-Cuevas, Jesús Machuca, Martin Wietzke, Magdalena Dammström, Roger Granström, Maria Corneliusson, Marita Skarstedt, Karin Frykfeldt, Carina Lindqvist Ivarsson, Adam Sergejev, Susanna Hagström, Ulrika Lidén, Johan Mölne, Hanna Ramström, Inga Fröding, Evangelos Alexandros Petropoulos, Karolina Ininbergs, Shah Jalal, A. Persson, Nina Kamenska, K. Granlund, Anna-Karin Smekal, A. W. Hill, Gunilla Rådberg, Gabriel Heyman, Lized Rodriguez, Lisa Vennberg, Gülşen­ Hazırolan, Işın Akyar, Gelmez Gülşen Altınkanat, Ayşe Nur Sarı Kaygısız,

Antibiotic Resistance in Bacteria

Abstract Objectives When bloodstream infections are caused by resistant bacteria, rapid antimicrobial susceptibility testing (RAST) is important for adjustment of therapy. The EUCAST RAST method, directly from positive blood cultures, was validated in a multi-laboratory study in Europe. Methods RAST was performed in 40 laboratories in northern Europe (NE) and 15 in southern Europe (SE) from clinical blood cultures positive for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus or Streptococcus pneumoniae. Categorical results at 4, 6 and 8 h of incubation were compared with results for EUCAST standard 16–20 h disc diffusion. The method, preliminary breakpoints and the performance of the laboratories were evaluated. Results The total number of isolates was 833/318 in NE/SE. The number of zone diameters that could be read (88%, 96% and 99%) and interpreted (70%, 81% and 85%) increased with incubation time (4, 6 and 8 h). The categorical agreement was acceptable, with total error rates in NE/SE of 2.4%/4.9% at 4 h, 1.1%/3.5% at 6 h and 1.1%/3.3% at 8 h. False susceptibility at 4, 6 and 8 h of incubation was below 0.3% and 1.1% in NE and SE, respectively, and the corresponding percentages for false resistance were below 1.9% and 2.8%. After fine-tuning breakpoints, more zones could be interpreted (73%, 89% and 93%), with only marginally affected error rates. Conclusions The EUCAST RAST method can be implemented in routine laboratories without major investments. It provides reliable antimicrobial susceptibility testing results for relevant bloodstream infection pathogens after 4–6 h of incubation.