Cost analysis of the Auto Microbic system urine identification card

Abstract

The AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) is a fully automated, computerized instrument. One of the most thoroughly studied aspects of the system is its ability to identify and quantify the nine most common urinary tract pathogens. The major advantages of the AutoMicrobic system are that the results of urine cultures are available in a fraction of the time required by conventional methods and that samples can be processed with fewer man-hours. Although the specificity, sensitivity, and reliability of the system have been amply described in the literature, only one study combines these aspects with a cost analysis (D.

Laboratory evaluation of leukocyte esterase and nitrite tests for the detection of bacteriuria

“…Many screening methods have been proposed to detect bacteria in urine on the day of collection, both to shorten the delay inherent in the culture system and to decrease the time spent in the laboratory separating negative specimens from those considered to have significant bacteriuria. These screening tests include several manual (4,5,8,13,15,18), semiautomated (10,11,14), and automated systems (7,9,10,17).…”

Use of rapid screening tests in processing urine specimens by conventional culture and the AutoMicrobic system

“…The AMS has been shown to be an accurate, relatively rapid, cost-effective system for specimens with -105 CFU/ml and provides detection, quantitation, and identification in 4 to 9 h in a high percentage of these specimens (8,10,11,21). However, it is not cost effective for processing specimens with <105 CFU/ml (8,21).…”

“…The AMS has been shown to be an accurate, relatively rapid, cost-effective system for specimens with -105 CFU/ml and provides detection, quantitation, and identification in 4 to 9 h in a high percentage of these specimens (8,10,11,21). However, it is not cost effective for processing specimens with <105 CFU/ml (8,21). Previous investigators have suggested that by screening urine specimens with a rapid screening test such as Gram stain (8) or the Autobac system (21) and processing positive specimens on the AMS and negative specimens by conventional culture one can take advantage of the rapid automation of the AMS and make it more cost effective to use on urine specimens.…”

“…A great deal of effort has been spent in the last several years in attempts to develop rapid, efficient methods of screening the large numbers of urine specimens submitted to the clinical microbiology laboratory. These screening tests include microscopic (9,17), chemical (2,4,17,22), and automated methods (2,6,8,(10)(11)(12)(13)(14)(15)18). The purpose of rapid screening of urine specimens is threefold.…”

“…Another interesting issue is the utility of performing these rapid urine screens in tandem with a highly automated urine processing instrument such as the AutoMicrobic system (AMS; Vitek Systems, Inc., Hazelwood, Mo.). Despite the fact that previous investigators have suggested that the performance of a screening test before processing urine specimens on the AMS would result in a much more cost-effective approach to automated urine culture and identification (8,21), there are very few published studies evaluating the role of the newer urine screening tests, such as the Chemstrip LN and the BTS, in conjunction with the AMS (2).…”