The Accelerate Pheno system is approved for rapid identification and phenotypic antimicrobial susceptibility testing (AST) of microorganisms grown from positive blood cultures inoculated with blood from septic patients. We evaluated the performance of the system for identification and AST from positive blood culture bottles inoculated with primary sterile nonblood specimens from patients with suspected severe infections. One hundred positive blood culture bottles with primary sterile specimens (63 cerebrospinal fluids, 16 ascites, 7 pleural fluids, 4 vitreous fluids, 5 joint aspirates, and 5 other aspirates) from 100 patients were included. Pathogen identification was in agreement with conventional methods for 72 of 100 cultures (72%) and for 81 of 112 (72%) pathogens when considering all pathogens and for 72 of 92 (78%) cultures and 81 of 104 (78%) pathogens when considering on-panel pathogens only. Eight of 31 isolates (26%) not identified by APS were pathogens not included in the APS panel. APS and conventional methods accordingly identified all pathogens from two of nine polymicrobial cultures (22%). APS generated antimicrobial resistance results for 57 pathogens of 57 cultures. The overall category agreement between APS and culture-based AST was 91.2%; and the rate for minor errors was 6.9%, for major was 1.7%, and for very major errors was 0.2%. APS may accelerate pathogen identification and phenotypic AST from positive blood culture bottles inoculated with primary sterile specimens from patients with serious infections, especially for hospitals without an on-site microbiology laboratory. However, the inclusion of nonblood specimens with a high likelihood of polymicrobial infections may result in an inferior performance.

中文翻译：

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使用 Accelerate Pheno 系统对接种疑似严重感染患者的原始无菌标本的阳性血培养瓶进行快速鉴定和抗微生物药敏试验的评价

Accelerate Pheno 系统已被批准用于快速鉴定和表型抗菌药敏试验 (AST)，微生物是从用脓毒症患者的血液接种的阳性血培养物中生长的。我们评估了系统的性能，用于从接种了疑似严重感染患者的初级无菌非血液标本的阳性血培养瓶中进行鉴定和 AST。包括来自 100 名患者的 100 个阳性血培养瓶，其中包含原始无菌标本（63 份脑脊液、16 份腹水、7 份胸水、4 份玻璃体液、5 份关节抽吸物和 5 份其他抽吸物）。当考虑所有病原体时，病原体鉴定与常规方法一致，用于 100 种培养物中的 72 种 (72%) 和 112 种病原体中的 81 种 (72%)，以及 92 种培养物中的 72 种 (78%) 和 104 种病原体中的 81 种 (78%)仅考虑面板上的病原体时。APS 未鉴定的 31 个分离株中有 8 个 (26%) 是 APS 面板中未包括的病原体。因此，APS 和常规方法从九种多微生物培养物中的两种（22%）中鉴定了所有病原体。APS 对 57 种培养物中的 57 种病原体产生了抗菌素耐药性结果。APS 与基于培养的 AST 的总体类别一致性为 91.2%；小错误率为 6.9%，大错误率为 1.7%，非常大错误率为 0.2%。APS 可能会加速病原体鉴定和阳性血培养瓶中接种严重感染患者的初级无菌标本的病原体和表型 AST，特别是对于没有现场微生物实验室的医院。但是，包含很可能发生多种微生物感染的非血液样本可能会导致性能下降。