BackgroundPatients infected with multi-drug-resistant (MDR) pathogens may experience long delays to targeted therapies due to the incomplete antimicrobial menus and/or breakpoints tested on current commercial antimicrobial susceptibility testing (AST) systems. Detection of carbapenem resistance poses a challenge to rapid, accurate, minimum inhibitory concentrations (MIC) determinations because some resistant organisms may be inhibited by a carbapenem antibiotic until sufficient carbapenemase production has been achieved and traditional AST platforms must wait to make MIC calls. More accurate carbapenem MICs can be determined by implementing a carbapenemase test alongside rapid AST.MethodsWe demonstrate a novel, proprietary test to detect carbapenemase production that enables rapid MIC testing for carbapenem antibiotics. The test is processed in parallel with the Selux next-generation phenotyping (NGP) AST method, enabling rapid, <6-hour, accurate MIC determinations. The carbapenemase assay utilizes high concentrations of intact bacteria. After 3 hours of incubation, a fluorescent pH indicator is read spectroscopically. The solution pH is lowered by carbapenemase-mediated imipenem degradation and is indicative of enzyme activity.ResultsThis assay accurately identifies carabapenemases across multiple enzyme classes and bacterial species. Figure 1 shows the accuracy and speed of NGP AST at determining MICs for representative isolates from the FDA-CDC antimicrobial resistance bank compared with results from overnight broth microdilution (BMD). To date, over 100 challenge strains of Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii have been tested with no very major errors and an average time-to-result of 5.3 hours.ConclusionBy incorporating a rapid, on-board carbapenemase activity assay, the NGP AST platform rapidly delivers accurate carbapenem results. Combined with NGP’s comprehensive antibiotic menus, this platform will therefore ensure prompt delivery of personalized antibiotic therapies for all patients, including those infected with MDROs, and enable streamlined antibiotic stewardship coordination. Disclosures All authors: No reported disclosures.
It is desired to perform accurate Near Infrared sensor measurements of slurries flowing in pipes leaving large batch reactors. A concern with these measurements is the degree to which the slurry sensed is representative of the material in the reactor and flowing through the pipe. Computational Fluid Dynamics (CFD) has been applied to the flow in the pipe to determine the flow fields and the concentration profiles seen by the sensors. The slurry was comprised of a xylene liquid phase and an ADP (2-amino-4, 6-dimethylpyrimidine) solid phase with a density ratio of 1.7. Computations were performed for a horizontal pipe with diameter 50.8 mm, length 2.032 m, and 1.76 m/s and 3.26 m/s mixture velocities. The corresponding pipe Reynolds numbers were 1.19E+05 and 2.21E+05. The flow through a slotted cylindrical probe inserted radially in the pipe also was considered. Spherical slurry particles with diameters from 10 μm to 1000 μm were considered with solid volume fractions of 12%, 24%, and 35%. Computations were performed with ANSYS FLUENT 12 software using the Realizable k-ε turbulence model and the enhanced wall treatment function. Comparisons of computed vertical profiles of solid volume fraction to results in the literature showed good agreement. Symmetric, nearly flat solid volume fraction profiles were observed for 38 μm particles for all three initial solid volume fractions. Asymmetric solid volume fraction profiles with greater values toward the bottom were observed for the larger particles. Changes in the profiles of turbulent kinetic energy also were observed. These changes are important for optical measurements which depend upon the mean concentration profiles as well as the turbulent motion of the slurry particles.
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