Evaluation of the Reveal<sup>®</sup> AST (SPECIFIC) for Antimicrobial Susceptibility Testing from Positive Blood Culture Spiked with Carbapenem-Resistant Isolates
Delphine Girlich,
Agnès B. Jousset,
Cécile Emeraud,
Inès Rezzoug,
Reece Burwell,
Pragya Singh,
Paul A. Rhodes,
Thierry Naas,
Rémy A. Bonnin,
Laurent Dortet
Affiliations
Delphine Girlich
Team “Resist” UMR1184 Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB), INSERM, Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
Agnès B. Jousset
Team “Resist” UMR1184 Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB), INSERM, Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
Cécile Emeraud
Team “Resist” UMR1184 Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB), INSERM, Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
Inès Rezzoug
Team “Resist” UMR1184 Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB), INSERM, Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
Reece Burwell
Specific Diagnostic, Mountain View, CA 94043, USA
Pragya Singh
Specific Diagnostic, Mountain View, CA 94043, USA
Paul A. Rhodes
Next Gen Diagnostics, Cambridge CB10 1SA, UK
Thierry Naas
Team “Resist” UMR1184 Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB), INSERM, Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
Rémy A. Bonnin
Team “Resist” UMR1184 Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB), INSERM, Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
Laurent Dortet
Team “Resist” UMR1184 Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB), INSERM, Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin-Bicêtre, France
As bloodstream infections and associated septic shock are common causes of mortality in hospitals, rapid antibiotic susceptibility testing (AST) performed directly on positive blood cultures is needed to implement an efficient therapy in clinical settings. We evaluated the Reveal® rapid AST system on a collection of 197 fully characterized carbapenem-resistant Enterobacterales, including 177 carbapenemase producers (CPE) spiked in blood culture bottles. The clinical categorization based on the Minimal Inhibitory Concentration (MIC) determination of eighteen antimicrobial molecules was compared to the clinical categorization based on the disk diffusion assay as a reference. The Reveal AST system provided results within a mean time to result of 5 h. Overall, the categorical agreement (CA) between the two techniques was 94.1%. The rates of very major errors (VMEs), major errors (MEs) and minor errors (mEs) were 3.8%, 3.7% and 5.6%, respectively. Imipenem was the antimicrobial with the lowest CA rate (78.7%), with rates of 15% VMEs and 10.7% MEs, but the performances were better when considering only the non-CPE category (CA of 89%). On this resistant collection of Enterobacterales with numerous acquired β-lactamases, the Specific Reveal assay proved to be useful for a rapid determination of AST compatible with a quick adaptation of the patient’s antimicrobial treatment.