We have evaluated the GenoType blood culture assay (Hain Lifescience, Nehren, Germany) for the identification of bacteria in 233 positive blood cultures and assessed its suitability in the workflow of a routine microbiology laboratory. In 68/233 (29.2%) samples, the culture result could not be confirmed by the GenoType assay due to a lack of primers in the test, multiple organisms in the sample, or inconsistency with respect to the identification by culture. Although the GenoType blood culture assay gives satisfactory results for bacteria for which primers are available, there are difficulties in applying the test in the routine microbiology laboratory. Blood culture has been the gold standard for the detection of sepsis pathogens. Continuously monitored blood culture systems have reduced the detection time of positive blood cultures, but there are few rapid and accurate methods for identifying pathogens directly from these samples. Nucleic-acid-based methods (DNA probe method, fluorescent in situ hybridization, PCR) (1, 3, 5, 7-9, 10-14) may offer one solution, and we have studied the accuracy and feasibility of one of them, the GenoType blood culture assay (Hain Lifescience, Nehren, Germany). The two GenoType BC panels identify 41 bacterial species. Additionally, the methicillin resistance-mediating mecA gene and the vancomycin resistance-mediating genes vanA, vanB, vanC1, and vanC2/C3 can be detected. The GenoType procedure includes three steps: DNA isolation, multiplex amplification with biotinylated primers, and strip-based reverse hybridization and detection.The [pediatric] bottle is taken). Normally, two sets (four bottles) are taken with at least 30 min between them. Gram staining from positive blood cultures was carried out to determine whether to use a GenoType BC GP (Gram-positive coccus) or GN (Gram-negative rod) test. The results were compared with those of routine identification methods used in our laboratory, including a DNA probe kit (Accuprobe, Gen-Probe, Inc., San Diego, CA) for preliminary detection of certain Gram-positive bacteria (enterococci, S. pyogenes, S. agalactiae, pneumococci, and Listeria monocytogenes); several biochemical tests, such as self-prepared oxidase (N,N,N=,N=-tetramethyl-p-phenylene diamine dihydrochloride in ethanol; Sigma-Aldrich Co., St. Louis, MO), selfprepared catalase (3% hydrogen peroxide; E. Merck, Darmstadt, Germany), and latex coagulase (Remel Europe Ltd., Crossways, Dartford, Kent, United Kingdom); and commercial test panels. Vitek2 (bioMérieux, Marcy l=Etoile, France) panels were used for the identification of Gram-negative rods complemented with biochemical tests such as oxidase and a self-prepared indole test (dimethylamino-cinnamaldehyde in hydrogen chloride; E. Merck, Darmstadt, Germany) and other commercial test panels (e.g., Api strips [bioMérieux, Marcy l=Etoile, France]). Antibiotic susceptibility testing was performed straight from the positive blood culture bottles by the disk diffusion method according to Finnish national guidelines based on the ...

Urine culture samples comprise a large proportion of the workload in clinical microbiology laboratories, and most of the urine samples show no growth or insignificant growth. A flow cytometry-based analyzer (Sysmex Corporation, Japan) has been used to screen out negative urine samples prior to culture in the Päijät-Häme district. We applied decision analytic modelling to analyze, from a laboratory perspective, the economic feasibility of the screening method as compared to culture only (conventional method) for diagnosis of urinary tract infection. Our model suggests that the least costly analytical strategy is the conventional method. The incremental cost of screening is €0.29/sample. Although laboratory costs are higher, considerable savings on workload can be achieved. Furthermore, screening has numerous benefits on the treatment process of a patient that well warrant the use of the screening method. We conclude that the incremental cost of screening the samples is worth the expense.