Rapid Antimicrobial Susceptibility Testing Using Forward Laser Light Scatter Technology

Hayden, Randall T.; Clinton, Lani K.; Hewitt, C.; Koyamatsu, Terri; Sun, Yilun; Jamison, Ginger R.; Perkins, Rosalie; Li, Tang; Pounds, Stanley; Bankowski, Matthew J.

doi:10.1128/jcm.01475-16

Cited by 40 publications

(32 citation statements)

References 30 publications

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“…The BacterioScan 216Dx instrument is well described in a recent publication by Hayden et al (19). Urine screening was performed by following the manufacturer's protocol.…”

Section: Methodsmentioning

confidence: 99%

“…This technology is based on the differential refraction of light by bacterial cells, which is algorithmically interpreted into a growth curve. A commercially available device with a modification of this technology termed narrow-angle forward laser light scattering has recently been reported for the rapid detection of antimicrobial resistance (19). This same device, BacterioScan 216Dx (BacterioScan, Inc., St. Louis, MO), is now advertised for urine screening; positive results suggest bacteriuria, and thus samples should be plated, while negative results can be considered true negatives, without the need for culture.…”

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confidence: 99%

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Prospective Evaluation of Light Scatter Technology Paired with Matrix-Assisted Laser Desorption Ionization – Time of Flight Mass Spectrometry for Rapid Diagnosis of Urinary Tract Infections

et al. 2017

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Urinary tract infections are one of the most common reasons for health care visits. Diagnosis and optimal treatment often require a urine culture, which takes an average of 1.5 to 2 days from urine collection to results, delaying optimal therapy. Faster, but accurate, alternatives are needed. Light scatter technology has been proposed for several years as a rapid screening tool, whereby negative specimens are excluded from culture. A commercially available light scatter device, BacterioScan 216Dx (BacterioScan, Inc.), has recently been advertised for this application. Paired use of mass spectrometry (MS) for bacterial identification and automatedsystem-based susceptibility testing straight from the light scatter suspension might provide dramatic improvement in times to a result. The present study prospectively evaluated the BacterioScan device, with culture as the reference standard. Positive light scatter specimens were used for downstream rapid matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) MS organism identification and automated-system-based antimicrobial susceptibility testing. Prospective evaluation of 439 urine samples showed a sensitivity of 96.5%, a specificity of 71.4%, and positive and negative predictive values of 45.1% and 98.8%, respectively. MALDI-TOF MS analysis of the suspension after density-based selection yielded a sensitivity of 72.1% and a specificity of 96.9%. Antimicrobial susceptibility testing of the samples identified by MALDI-TOF MS produced an overall categorical agreement of 99.2%. Given the high sensitivity and negative predictive value of results obtained, BacterioScan 216Dx is a reasonable approach for urine screening and might produce negative results in as few as 3 h, with no downstream workup. Paired rapid identification and susceptibility testing might be useful when MALDI-TOF MS results in an organism identification, and it might decrease the time to a result by more than 24 h. KEYWORDS mass spectrometry, susceptibility testing, urinary tract infection U rinary tract infections (UTI) are a leading cause of health care visits in the United States (1). Consequently, urine cultures are one of the most frequently ordered tests in clinical microbiology laboratories (2). Given that culture requires 18 to 24 h for pathogen growth and an additional 18 to 48 h for identification (ID) and antimicrobial susceptibility testing (AST) results, rapid alternatives are needed to streamline therapy. Screening tests, including point-of-care leukocyte esterase and nitrite detection, exist; however, these tests often produce false negatives, particularly in the setting of

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“…The BacterioScan 216Dx instrument is well described in a recent publication by Hayden et al (19). Urine screening was performed by following the manufacturer's protocol.…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Prospective Evaluation of Light Scatter Technology Paired with Matrix-Assisted Laser Desorption Ionization – Time of Flight Mass Spectrometry for Rapid Diagnosis of Urinary Tract Infections

et al. 2017

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“…The system utilizes forward laser lightscattering technology to rapidly screen urine for the presence of bacteria at a limit of detection of 10 3 CFU/ml. The technology has been proven to perform AST directly from urine samples with promising results [43,44]. An innovative approach from Accelerate Diagnostics is the development of a lower respiratory tract panel on the Pheno System (described above).…”

Section: New Rapid Ast Technologies In the Pipelinementioning

confidence: 99%

Why Can't We Just Use PCR? The Role of Genotypic versus Phenotypic Testing for Antimicrobial Resistance Testing

Bard

Lee

2018

Clinical Microbiology Newsletter

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“…This system uses a laser light source to measure the concentration of particles in the liquid samples (optical density-OD) as well as the scattered intensity in a direction near to the laser beam. Due to the use of FLLS, the OD can be measured accurately up to 2 orders of magnitude lower than traditional methods leading to low threshold concentrations of ~ 10,000 CFU/ml [21] in comparison to current methods. The system can be used to run up to 16 samples simultaneously, with measurements done automatically every 3 minutes for accurate density change measurements.…”

Section: Emerging Technologiesmentioning

confidence: 99%

A Comprehensive Review of the Present and Future Antibiotic Susceptibility Testing (AST) Systems

Puttaswamy¹,

Gupta²,

Regunath³

et al. 2018

Arch Clin Microbiol

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Tools and instruments available in the clinical microbiology labs for analysis of patient samples and diagnosis are constantly evolving. The main impetus behind this is to decrease the overall time taken to obtain the results from the instruments, enhance the ease of sample processing, increasing the sample turn-around time with the ultimate goal of earlier patient treatment and better recovery rates. This is especially true in the case of antibiotic susceptibility testing (AST), where every hour saved in obtaining the results leading to an earlier switch to targeted antibiotic therapy will have a direct influence on improving clinical outcomes. Reduction in the time to obtain AST results reduces the duration of use of broad-spectrum antibiotics, which in turn decreases the emergence of antibiotic resistance among bacteria. Many of the traditional methods available for AST are labor intensive and slow despite being precise in obtaining results. Thus, there is a trend towards development and use of automated diagnostic devices which are rapid and easy to use. This review article provides a detailed summary of traditional AST methods, currently used automated methods, and focuses on some of the promising emerging and future technologies in the field of rapid antibiotic susceptibility profiling.

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Rapid Antimicrobial Susceptibility Testing Using Forward Laser Light Scatter Technology

Cited by 40 publications

References 30 publications

Prospective Evaluation of Light Scatter Technology Paired with Matrix-Assisted Laser Desorption Ionization – Time of Flight Mass Spectrometry for Rapid Diagnosis of Urinary Tract Infections

Prospective Evaluation of Light Scatter Technology Paired with Matrix-Assisted Laser Desorption Ionization – Time of Flight Mass Spectrometry for Rapid Diagnosis of Urinary Tract Infections

Why Can't We Just Use PCR? The Role of Genotypic versus Phenotypic Testing for Antimicrobial Resistance Testing

A Comprehensive Review of the Present and Future Antibiotic Susceptibility Testing (AST) Systems

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