Evaluation of the Accelerate Pheno System: Results from Two Academic Medical Centers

Lutgring, Joseph D.; Bittencourt, Cassiana E.; TeKippe, Erin McElvania; Cavuoti, Dominick; Hollaway, Rita; Burd, Eileen M.

doi:10.1128/jcm.01672-17

Cited by 69 publications

(37 citation statements)

References 32 publications

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“…However, we used a previous version of the software; the new version of this software includes an algorithm modification to optimize its performance. A recent study established an overall sensitivity and specificity for yeasts of 83.3% and 98.4%, respectively (8). The overall essential agreement and the overall category agreement in our study concurs with the multicentre study of Pancholi and colleagues which reported values of 97% (9).…”

Section: Discussionsupporting

confidence: 91%

Evaluation of the Accelerate Pheno™ system to identify bacteria and determine antimicrobial susceptibility in positive blood cultures

Fernández-Pittol¹,

Morales²,

Rubio³

et al. 2019

Preprint

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Introduction. New platforms have recently been developed to reduce response time of identification and antimicrobial susceptibility of bacterial isolates in positive blood cultures from patients with bloodstream infections. The Accelerate Pheno TM system (Accelerate Diagnostics, Inc.) provides information on pathogen identification and antibiotic susceptibility in approximately 1.5 and 7 hours, respectively. Methods. In this study we compared the Accelerate Pheno TM system with the standard procedure used in our laboratory. A total of 41 blood cultures were prospectively analysed with the Accelerate Pheno TM system and our standard methods, which include identification by MALDI-TOF mass spectrometry and antibiotic susceptibility testing (AST) by BD Phoenix system and E-test. Results. The correlation between the two methods using Cohen's kappa coefficient was 0.82; mean (sd) time of identification for MALDI-TOF MS was 0.7 (0.22) hours and 1.43 (0.14) hours for the Accelerate PhenoTM system. The mean (sd) time of AST with the BD Phoenix system was 15.85 (2.57) hours and with the Accelerate Pheno TM system 6.7 (0.12) hours. AST results showed an overall essential agreement of 92% for the minimal inhibitory concentrations (MIC) and an overall category agreement of 96%. Among Gram positive isolates, essential and category agreements of 100% were observed. In Gram negative isolates 10 discrepancies were detected, which were classified as 7 major and 3 minor errors. Discrepancies in the Accelerate Pheno TM system were observed particularly for P. aeruginosa. Conclusion. The Accelerate Pheno TM system can improve turnaround time in the management of patients with bloodstream infections. Sepsis | Accelerate Pheno TM | Microbiology| Blood cultures | DiagnosticsCorrespondence: ccasals@clinic.cat

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Section: Discussionsupporting

confidence: 91%

Evaluation of the Accelerate Pheno™ system to identify bacteria and determine antimicrobial susceptibility in positive blood cultures

Fernández-Pittol¹,

Morales²,

Rubio³

et al. 2019

Preprint

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“…A recent experience from two academic medical centers in the United States has shed some light on the utility of this platform for clinical use. 70 Among 298 blood cultures included in the study, the Accelerate Pheno System provided definitive ID results in 218 instances (73.2%) and an AST result was available for analysis in 146 instances. The overall category agreement was 94.1% with five very major errors and four major errors after a discrepancy assessment.…”

Section: Accelerate Pheno Systemmentioning

confidence: 99%

Novel Approaches to Hasten Detection of Pathogens and Antimicrobial Resistance in the Intensive Care Unit

Guillamet

Burnham

Kollef

2019

Semin Respir Crit Care Med

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Antibiotic resistance is recognized as a key determinant of outcome in patients with serious infections influencing empiric antibiotic practices especially for critically ill patients. Within the intensive care unit (ICU), nosocomial infections and increasingly community-onset infections are caused by multidrug-resistant bacteria. Escalating rates of antibiotic resistance adds substantially to the morbidity, mortality, and cost related to infections treated in the ICU. Both gram-positive organisms, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, and gram-negative bacteria, including Pseudomonas aeruginosa, Acinetobacter species, carbapenem-resistant Enterobacteriaceae, and extended spectrum β-lactamase producing organisms, are urgent threats. The rising rates of antimicrobial resistance have resulted in routine empiric administration of broad-spectrum antibiotics by clinicians to critically ill patients even when bacterial infection is microbiologically absent. Moreover, new broad-spectrum antibiotics are a challenge to use effectively while avoiding emergence of further resistance. Use of rapid diagnostic technologies (RDTs) will likely provide an important methodology for achieving this important balance. There is an urgent need for integrating the administration of new and existing antibiotics with RDTs in a way that is safe, cost-effective, applicable in all countries, and sustainable.

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“…For AST, the overall agreement was 95.4% for essential and 94.3% for categorical agreements, compared to traditional methods. Other recent publications further describe its use (52)(53)(54).…”

Section: Accelerate Pheno Systemmentioning

confidence: 99%

Rapid Diagnostics for Blood Cultures: Supporting Decisions for Antimicrobial Therapy and Value-Based Care

Wolk

Johnson

2019

The Journal of Applied Laboratory Medicine

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Bacteremia and sepsis are critically important syndromes with high mortality, morbidity, and associated costs. Bloodstream infections and sepsis are among the top causes of mortality in the US, with >600 deaths each day. Most septic patients can be found in emergency medicine departments or critical care units, settings in which rapid administration of targeted antibiotic therapy can reduce mortality. Unfortunately, routine blood cultures are not rapid enough to aid in the decision of therapeutic intervention at the onset of bacteremia. As a result, empiric, broad-spectrum treatment is common-a costly approach that may fail to target the correct microbe effectively, may inadvertently harm patients via antimicrobial toxicity, and may contribute to the evolution of drug-resistant microbes. To overcome these challenges, laboratorians must understand the complexity of diagnosing and treating septic patients, focus on creating algorithms that rapidly support decisions for targeted antibiotic therapy, and synergize with existing emergency department and critical care clinical practices put forth in the Surviving Sepsis Guidelines. IMPACT STATEMENTPatients infected with bacteria in their bloodstream can benefit from deployment of laboratory technology that is more rapid and more accurate than historical methods. This review will characterize the current and novel laboratory technology and the potential effect of technology to improve care for patients with blood stream infections. The review provides a snapshot of emerging technologies for laboratorians to consider as they strategize about how best to support quality initiatives focusing on sepsis in their organizations.

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Evaluation of the Accelerate Pheno System: Results from Two Academic Medical Centers

Cited by 69 publications

References 32 publications

Evaluation of the Accelerate Pheno™ system to identify bacteria and determine antimicrobial susceptibility in positive blood cultures

Evaluation of the Accelerate Pheno™ system to identify bacteria and determine antimicrobial susceptibility in positive blood cultures

Novel Approaches to Hasten Detection of Pathogens and Antimicrobial Resistance in the Intensive Care Unit

Rapid Diagnostics for Blood Cultures: Supporting Decisions for Antimicrobial Therapy and Value-Based Care

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