Abstract
Administering appropriate antimicrobial therapy as early as possible is important for rescuing bacteremic patients. Therefore, rapid antimicrobial susceptibility tests in positive blood culture specimens have been diligently sought. Adenosine triphosphate (ATP) bioluminescence-based methods have been used for rapid antimicrobial susceptibility tests. However, blood culture specimens have not been examined in many studies, possibly due to abundant intracellular ATP in blood corpuscles resulting in false-susceptible results. In this study, we developed a rapid ATP bioluminescence-based method for detecting antibiotic resistance starting from positive blood culture. To minimize background ATP originating from blood corpuscles, specimens were centrifuged and the supernatant diluted with broth, and an ATP-eliminating reagent was then added to the bacterial suspension at the beginning of incubation. This newly devised procedure reduced the background ATP by more than five orders of magnitude. In a pilot study using levofloxacin, no false-susceptible results were observed in 15 clinical specimens. Furthermore, the results indicated that the rapid method provided additional information about bacterial activities with high resolution, in contrast to the less-thorough findings with the conventional turbidity method. Therefore, our approach will contribute to the treatment of infectious diseases as a rapid antimicrobial susceptibility test.
Highlights
Bacterial infections remain a medical burden, and despite the development of many classes of antibiotics, the burden has only increased with time, as the emergence of antibiotic resistant bacteria has become a worldwide problem
In the present study, employing newly devised sample preparation procedures, we developed a rapid adenosine triphosphate (ATP) bioluminescence-based method for detecting antibiotic resistance starting from positive blood culture bottles, and demonstrated rapid levofloxacin resistance detection
Workflow of the rapid ATP bioluminescence-based method for detecting levofloxacin resistance starting from positive blood culture bottles
Summary
Bacterial infections remain a medical burden, and despite the development of many classes of antibiotics, the burden has only increased with time, as the emergence of antibiotic resistant bacteria has become a worldwide problem. Systemic bacterial infections, such as sepsis, are frequently accompanied by bacteremia and a more rapid antimicrobial susceptibility test would be preferable in such cases, specimens taken directly from positive blood culture bottles have not been examined yet. This is because the abundant intracellular ATP derived from blood corpuscles could become a great obstacle for detecting bacterial growth. In the present study, employing newly devised sample preparation procedures, we developed a rapid ATP bioluminescence-based method for detecting antibiotic resistance starting from positive blood culture bottles, and demonstrated rapid levofloxacin resistance detection
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