Abstract
Background. Early detection of Gram-positive bacteremia and timely appropriate antimicrobial therapy are required for decreasing patient mortality. The purpose of our study was to evaluate the performance of the Verigene Gram-positive blood culture assay (BC-GP) in two special healthcare settings and determine the potential impact of rapid blood culture testing for Gram-positive bacteremia within the Japanese healthcare delivery system. Furthermore, the study included simulated blood cultures, which included a library of well-characterized methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) isolates reflecting different geographical regions in Japan. Methods. A total 347 BC-GP assays were performed on clinical and simulated blood cultures. BC-GP results were compared to results obtained by reference methods for genus/species identification and detection of resistance genes using molecular and MALDI-TOF MS methodologies. Results. For identification and detection of resistance genes at two clinical sites and simulated blood cultures, overall concordance of BC-GP with reference methods was 327/347 (94%). The time for identification and antimicrobial resistance detection by BC-GP was significantly shorter compared to routine testing especially at the cardiology hospital, which does not offer clinical microbiology services on weekends and holidays. Conclusion. BC-GP generated accurate identification and detection of resistance markers compared with routine laboratory methods for Gram-positive organisms in specialized clinical settings providing more rapid results than current routine testing.
Highlights
Gram-positive bacteria are the most predominant microorganisms associated with sepsis in healthcare settings and the most prevalent cause of bacteremia in patients with hematopoietic stem cell transplantation [1, 2]
96/104 (92%) organisms were correctly identified by BC-GP to the species or genus level including detection of resistance genes
The performance of BC-GP observed in our study was similar to previous reports [12,13,14,15,16, 31,32,33]
Summary
Gram-positive bacteria are the most predominant microorganisms associated with sepsis in healthcare settings and the most prevalent cause of bacteremia in patients with hematopoietic stem cell transplantation [1, 2]. Infective endocarditis, infectious aneurysm, catheter-related bloodstream infections, or surgical site infections after cardiac surgeries are the major infections of which the most common causative microorganisms are Grampositive cocci [5,6,7,8,9,10] In both medical units, early detection of Canadian Journal of Infectious Diseases and Medical Microbiology. For identification and detection of resistance genes at two clinical sites and simulated blood cultures, overall concordance of BC-GP with reference methods was 327/347 (94%). BC-GP generated accurate identification and detection of resistance markers compared with routine laboratory methods for Gram-positive organisms in specialized clinical settings providing more rapid results than current routine testing
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