Direct, rapid antimicrobial susceptibility test from positive blood cultures based on microscopic imaging analysis
Jungil Choi, Hyun Yong Jeong, Gi Yoon Lee, Sangkwon Han, Shinhun Han, Bonghwan Jin, Taegeun Lim, Shin Kim, Dong Young Kim, Hee Chan Kim, Eui-Chong Kim, Sang Hoon Song, Taek Soo Kim, Sunghoon Kwon, Jungil Choi, Hyun Yong Jeong, Gi Yoon Lee, Sangkwon Han, Shinhun Han, Bonghwan Jin, Taegeun Lim, Shin Kim, Dong Young Kim, Hee Chan Kim, Eui-Chong Kim, Sang Hoon Song, Taek Soo Kim, Sunghoon Kwon
Abstract
For the timely treatment of patients with infections in bloodstream and cerebrospinal fluid, a rapid antimicrobial susceptibility test (AST) is urgently needed. Here, we describe a direct and rapid antimicrobial susceptibility testing (dRAST) system, which can determine the antimicrobial susceptibility of bacteria from a positive blood culture bottle (PBCB) in six hours. The positive blood culture sample is directly mixed with agarose and inoculated into a micropatterned plastic microchip with lyophilized antibiotic agents. Using microscopic detection of bacterial colony formation in agarose, the total time to result from a PBCB for dRAST was only six hours for a wide range of bacterial concentrations in PBCBs. The results from the dRAST system were consistent with the results from a standard AST, broth microdilution test. In tests of clinical isolates (n = 206) composed of 16 Gram-negative species and seven Gram-positive species, the dRAST system was accurate compared to the standard broth microdilution test, with rates of 91.11% (2613/2868) categorical agreement, 6.69% (192/2868) minor error, 2.72% (50/1837) major error and 1.45% (13/896) very major error. Thus, the dRAST system can be used to rapidly identify appropriate antimicrobial agents for the treatment of blood stream infection (BSI) and antibiotic-resistant strain infections.
Conflict of interest statement
J.C., Shinhun.H., B.J., D.Y.K., Sangkwon.H. and S.K. (QuantaMatrix Inc.) at the time of manuscript submission, were employed at QuantaMatrix, Inc., which is commercializing the dRAST technology. J.C., Shinhun.H., B.J., D.Y.K., Sangkwon.H. and S.K. (QuantaMatrix Inc.) have equity interest in QuantaMatrix, Inc.
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