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dc.contributor.authorFalconer, Kerry
dc.contributor.authorHammond, Robert
dc.contributor.authorParcell, Benjamin John
dc.contributor.authorGillespie, Stephen Henry
dc.identifier.citationFalconer , K , Hammond , R , Parcell , B J & Gillespie , S H 2024 , ' Rapid determination of antimicrobial susceptibility of Gram-negative bacteria from clinical blood cultures using a scattered light integrated collection (SLIC) device ' , Journal of Medical Microbiology , vol. 73 , no. 2 , 001812 .
dc.identifier.otherORCID: /0000-0001-6537-7712/work/154532279
dc.identifier.otherORCID: /0000-0003-3664-3641/work/157140942
dc.descriptionFunding: This work was funded by the University of St Andrews.en
dc.description.abstractBackground A bloodstream infection (BSI) presents a complex and serious health problem, a problem that is being exacer- bated by increasing antimicrobial resistance (AMR). Gap statement The current turnaround times (TATs) for most antimicrobial susceptibility testing (AST) methods offer results retrospective of treatment decisions, and this limits the impact AST can have on antibiotic prescribing and patient care. Progress must be made towards rapid BSI diagnosis and AST to improve antimicrobial stewardship and reduce preventable deaths from BSIs. To support the successful implementation of rapid AST (rAST) in hospital settings, a rAST method that is affordable, is sustainable and offers comprehensive AMR detection is needed. Aim To evaluate a scattered light-integrated collection (SLIC) device against standard of care (SOC) to determine whether SLIC could accelerate the current TATs with actionable, accurate rAST results for Gram-negative BSIs. Methods Positive blood cultures from a tertiary referral hospital were studied prospectively. Flagged positive Gram-negative blood cultures were confirmed by Gram staining and analysed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, Vitek 2, disc diffusion (ceftriaxone susceptibility only) and an SLIC device. Susceptibility to a panel of five antibiotics, as defined by European Committee on Antimicrobial Susceptibility Testing breakpoints, was examined using SLIC. Results A total of 505 bacterial–antimicrobial combinations were analysed. A categorical agreement of 95.5 % (482/505) was achieved between SLIC and SOC. The 23 discrepancies that occurred were further investigated by the broth microdilution method, with 10 AST results in agreement with SLIC and 13 in agreement with SOC. The mean time for AST was 10.53±0.46 h and 1.94±0.02 h for Vitek 2 and SLIC, respectively. SLIC saved 23.96±1.47 h from positive blood culture to AST result. Conclusion SLIC has the capacity to provide accurate AST 1 day earlier from flagged positive blood cultures than SOC. This significant time saving could accelerate time to optimal antimicrobial therapy, improving antimicrobial stewardship and man- agement of BSIs.
dc.relation.ispartofJournal of Medical Microbiologyen
dc.subjectAntimicrobial resistanceen
dc.subjectAntimicrobial stewardshipen
dc.subjectAntimicrobial susceptibility testingen
dc.subjectBlood cultureen
dc.subjectBloodstream infectionen
dc.subjectRapid diagnosticsen
dc.subjectQR Microbiologyen
dc.titleRapid determination of antimicrobial susceptibility of Gram-negative bacteria from clinical blood cultures using a scattered light integrated collection (SLIC) deviceen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. Infection and Global Health Divisionen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Sir James Mackenzie Institute for Early Diagnosisen
dc.contributor.institutionUniversity of St Andrews. Centre for Biophotonicsen
dc.contributor.institutionUniversity of St Andrews. Global Health Implementation Groupen
dc.contributor.institutionUniversity of St Andrews. Biomedical Sciences Research Complexen
dc.description.statusPeer revieweden

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