Table 1.
Rapid Molecular and/or Phenotypic Methods Performed on Positive Blood Culture Broths
| Manufacturer/Platform/Method | Panel | Organism Groups Detecteda | No. of Organism Targets | Antimicrobial Resistance Marker Targets | ||||
|---|---|---|---|---|---|---|---|---|
| Extended-Spectrum β-Lactamase Family | Carbapenemase Family | Colistin Resistance | Methicillin Resistance | Vancomycin Resistance | ||||
| Genotypic methods | ||||||||
| BioFire (bioMérieux) Filmarray | BCID | Gram-positive bacteria, Gram-negative bacteria and yeast | 24 | … | bla KPC | … | mecA | vanA/B |
| … | BCID2 | Gram-positive bacteria, Gram-negative bacteria and yeast | 33 | bla CTX-M | bla KPC bla NDM bla VIM bla IMP bla OXA-48 | mcr-1 |
mecA/C
mecA/C and MREJb |
vanA/B |
| GenMark (Roche) ePlex | BCID-GP | Gram-positive bacteria | 20 | … | … | … | mecA/C | vanA/B |
| … | BCID-GN | Gram-negative bacteria | 21 | bla CTX-M | bla KPC bla NDM bla VIM bla IMP bla OXA-48/blaOXA-23 | … | … | … |
| … | BCID-FP | Yeast and Fusarium species | 15 | … | … | … | … | … |
| Luminex Verigene | BC-GP | Gram-positive bacteria | 12 | … | … | … | mecA | vanA/B |
| … | BC-GN | Gram-negative bacteria | 9 | bla CTX-M | bla KPC bla NDM bla VIM bla IMP bla OXA-48 | … | … | … |
| Great Basin diagnostic system | Staph ID/R PCR | Staphylococcus aureus, Staphylococcus lugdunensis, Staphylococcus species other than aureus and lugdunensis | 3 | … | … | … | mecA | … |
| Becton Dickinson BD MAX | StaphSR | S. aureus | 1 | … | … | … | mecA/C and MREJ | … |
| Cepheid GeneXpert | Xpert MRSA/SA BC | S. aureus | 1 | … | … | … | mecA and MREJ | … |
| Proteomic method | ||||||||
| Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry performed directly from positive blood culture broths (e.g., SepsiTyper) | NA | NAc | NA | … | … | … | … | … |
| Phenotypic methods | ||||||||
| Accelerate— fluorescent in situ hybridization based identification and phenotypic AST | PhenoTest BC | Gram-positive bacteria,Gram-negative bacteria and yeast | 16 | … | … | … | … | … |
| Rapid disk diffusion AST method performed directly from positive blood culture broth | NA | NA | NA | … | … | … | … | … |
Abbreviations: AST, antimicrobial susceptibility testing; BC, blood culture; BCID, blood culture identification; FP, fungal panel; GN, Gram-negative; GP, Gram-positive; ID, identification; MALDI-TOF MS, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; MRSA, methicillin-resistant Staphylococcus aureus; NA, not applicable; PCR, polymerase chain reaction; SA: Staphylococcus aureus.
Individual targets differ based on the panel and platform.
MREJ is a molecular target for the junction of the staphylococcal cassette chromosome mec element (SCCmec; a chromosomal cassette harboring mecA or mecC) and orfX in order to specifically link the mecA/C gene to Staphylococcus aureus in order to identify methicillin-resistant Staphylococcus aureus.
Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry is capable of detecting an array of Gram-positive bacteria, Gram-negative bacteria, acid-fast bacilli, and fungi. The reliability of identification is dependent on the database applied.