title: Antibiotic treatment algorithm development based on a microarray nucleic acid assay for rapid bacterial identification and resistance determination from positive blood cultures.
abstract: Rapid diagnosis of bloodstream infections remains a challenge for the early targeting of an antibiotic therapy in sepsis patients. In recent studies, the reliability of the Nanosphere Verigene Gram-positive and Gram-negative blood culture (BC-GP and BC-GN) assays for the rapid identification of bacteria and resistance genes directly from positive BCs has been demonstrated. In this work, we have developed a model to define treatment recommendations by combining Verigene test results with knowledge on local antibiotic resistance patterns of bacterial pathogens. The data of 275 positive BCs were analyzed. Two hundred sixty-three isolates (95.6%) were included in the Verigene assay panels, and 257 isolates (93.5%) were correctly identified. The agreement of the detection of resistance genes with subsequent phenotypic susceptibility testing was 100%. The hospital antibiogram was used to develop a treatment algorithm on the basis of Verigene results that may contribute to a faster patient management.
authors.affiliation: Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany. Electronic address: juergen.roedel@med.uni-jena.de.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rödel
authors.affiliation: Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Karrasch
authors.affiliation: Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Edel
authors.affiliation: Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Stoll
authors.affiliation: Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bohnert
authors.affiliation: Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Löffler
authors.affiliation: Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Saupe
authors.affiliation: Institute of Medical Microbiology, University Hospital of Jena, Erlanger Allee 101, D-07747 Jena, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Pfister
mesh_terms: D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects / Q000235:genetics; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests; D020411:Oligonucleotide Array Sequence Analysis / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000900:Anti-Bacterial Agents
keywords: Blood culture; Sepsis; Verigene array; antimicrobial stewardship