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Digital imaging for reading of direct rapid antibiotic susceptibility tests from positive blood cultures

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Abstract

Delaying effective antibiotic therapy is a major cause of sepsis-associated mortality. The EUCAST rapid antibiotic susceptibility test (RAST) is performed from positive blood cultures to provide rapid results. Disc diffusion tests inoculated with positive blood culture broth are read at 4, 6, and 8 h and interpreted against species and time-specific criteria. Potential problems are the possibility of missing specific reading times for tests and slower growth in incubators that are frequently opened. The current study aimed to assess if digital visualization by the BD Kiestra™ total laboratory automation system is suitable for reading RASTs by capturing images at the correct times and retaining them for review. Utilizing the Kiestra™ InoqulA, 100 μl of positive blood culture broth was lawn-inoculated onto Mueller-Hinton agar and incubated at 35 °C for automated digital zone measurement at 4, 6, and 8 h. Aliquots from 135 positive blood cultures were tested against EUCAST-recommended and other drugs and assessed for readability of digital images. Microdilution MICs were determined in parallel to RASTs. All isolates except 7/10 enterococci yielded images of suitable quality for zone measurement. Of the 641 digitally read tests for other organisms, 207 (32.3%) were readable in 4 h, 555 (86.6%) in 6 h, and 641 (100%) in 8 h. For tests included in EUCAST criteria, 92.1% provided categorical agreement with microdilution MICs. Digital image reading of RASTs is a potentially viable, inexpensive tool for providing rapid susceptibility results which can help reduce sepsis-associated mortality.

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Acknowledgements

We thank our colleagues at the Microbiology Department of the University of Louisville Hospital, Louisville, KY, USA, for the assistance with the conduct of this study.

Availability of data

The datasets generated and/or analyzed during the current study are available from KST (kenneth.thomson20@gmail.com) on reasonable request.

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Authors and Affiliations

  1. Microbiology Department, University of Louisville Hospital, 530 South Jackson St, Louisville, KY, 40202, USA

    Gina K. Thomson & Kira Jamros

  2. Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Louisville, KY, USA

    Gina K. Thomson, James W. Snyder & Kenneth S. Thomson

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  1. Gina K. Thomson
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  2. Kira Jamros
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  4. Kenneth S. Thomson
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Contributions

The contributions from the respective authors were as follows: Thomson, G. and Jamros, K, design and technical oversight of the study, data acquisition, analysis and interpretation of data, drafting and revising the manuscript for intellectual content, and final approval for submission; Thomson, K., analysis and interpretation of data, drafting and revising the manuscript for intellectual content, and final approval for submission; Snyder, J., analysis and interpretation of data, drafting and revising the manuscript for intellectual content, and final approval for submission.

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Correspondence to Gina K. Thomson.

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Thomson, G.K., Jamros, K., Snyder, J.W. et al. Digital imaging for reading of direct rapid antibiotic susceptibility tests from positive blood cultures. Eur J Clin Microbiol Infect Dis 40, 2105–2112 (2021). https://doi.org/10.1007/s10096-021-04249-8

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