Author/Authors :
Kikuchi, Ken Department of Infectious Diseases - Tokyo Women’s Medical University, Tokyo, Japan , Matsuda, Mari Department of Infection Control Science - Faculty of Medicine - Juntendo University, Japan , Iguchi, Shigekazu Department of Infectious Diseases - Tokyo Women’s Medical University, Tokyo, Japan , Mizutani, Tomonori Department of Infection Control Science - Faculty of Medicine - Juntendo University, Japan , Hiramatsu, Keiichi Department of Infection Control Science - Faculty of Medicine - Juntendo University, Japan , Tega-Ishii, Michiru Sakakibara Heart Institute, Tokyo, Japan , Sansaka, Kaori Sakakibara Heart Institute, Tokyo, Japan , Negishi, Kenta Sakakibara Heart Institute, Tokyo, Japan , Shimada, Kimie Sakakibara Heart Institute, Tokyo, Japan , Umemura, Jun Sakakibara Heart Institute, Tokyo, Japan , Notake, Shigeyuki Miroku Medical Laboratory Inc - Nagano, Japan
Abstract :
Background. Early detection of Gram-positive bacteremia and timely appropriate antimicrobial therapy are required for decreasing patient mortality. The purpose of our study was to evaluate the performance of the Verigene Gram-positive blood culture assay (BC-GP) in two special healthcare settings and determine the potential impact of rapid blood culture testing for Gram-positive bacteremia within the Japanese healthcare delivery system. Furthermore, the study included simulated blood cultures, which included a library of well-characterized methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) isolates reflecting different geographical regions in Japan. Methods. A total 347 BC-GP assays were performed on clinical and simulated blood cultures. BC-GP results were compared to results obtained by reference methods for genus/species identification and detection of resistance genes using molecular and MALDI-TOF MS methodologies. Results. For identification and detection of resistance genes at two clinical sites and simulated blood cultures, overall concordance of BC-GP with reference methods was 327/347 (94%). The time for identification and antimicrobial resistance detection by BC-GP was significantly shorter compared to routine testing especially at the cardiology hospital, which does not offer clinical microbiology services on weekends and holidays. Conclusion. BC-GP generated accurate identification and detection of resistance markers compared with routine laboratory methods for Gram-positive organisms in specialized clinical settings providing more rapid results than current routine testing.
