title: Rapid identification and antimicrobial susceptibility profiling of Gram-positive cocci in blood cultures with the Vitek 2 system.
abstract: Rapid identification and antimicrobial susceptibility profiling of the bacteria in blood cultures can result in clinical and financial benefits. Addition of saponin to the fluid from blood culture bottles promotes the recovery of the bacteria and thus may shorten the turnaround time of the microbiological analyses. In this study we compared the identification and susceptibility profiles of saponin-treated and untreated (standard method) blood cultures monomicrobial for Gram-positive cocci using Vitek 2. We concordantly identified 49 (89%) of 55 monobacterial cultures using the results with the standard method as reference. Complete categorical agreement between the susceptibility profiles with the new and the standard method was found for 26 (53%) of 49 isolates, while discrepancies were seen for 23 (47%) cultures. E-tests indicated that the new method resulted in a correct susceptibility profile for 8 (35%) of these 23 blood cultures. Therefore, 34 (69%) of 49 cultures showed a concordant/correct susceptibility profile for all antimicrobials with an overall error rate of 2.3%. Thus, addition of saponin to the fluid from blood culture bottles of the Bactec 9240 leads to the rapid (results available >or=12 hours earlier) and reliable identification and susceptibility profiling of Gram-positive cocci in blood cultures with Vitek 2.
authors.affiliation: Dipartimento di Patologia Sperimentale, Biotecnologie Mediche, Infettivologia ed Epidemiologia, Università di Pisa, Pisa, Italy. alupetti@biomed.unipi.it
authors.forename: A
authors.initials: A
authors.lastname: Lupetti
authors.forename: S
authors.initials: S
authors.lastname: Barnini
authors.forename: B
authors.initials: B
authors.lastname: Castagna
authors.forename: A-L
authors.initials: AL
authors.lastname: Capria
authors.forename: P H
authors.initials: PH
authors.lastname: Nibbering
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology*; D001431:Bacteriological Techniques / Q000379:methods*; D001769:Blood / Q000382:microbiology*; D003902:Detergents / Q000494:pharmacology; D006095:Gram-Positive Cocci / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*; D006801:Humans; D011237:Predictive Value of Tests; D012503:Saponins / Q000494:pharmacology; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D003902:Detergents; D012503:Saponins