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Journal of Clinical Microbiology, July 1998, p. 2052-2056, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Direct Susceptibility Testing with Positive BacT/Alert Blood Cultures by Using MicroScan Overnight and Rapid Panels

Ken B. Waites,1,* E. S. Brookings,1 S. A. Moser,1 and B. L. Zimmer2

Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama,1 and Dade MicroScan, Inc., West Sacramento, California2

Received 4 December 1997/Returned for modification 16 March 1998/Accepted 24 April 1998

Studies were conducted on a method of direct inoculation of MicroScan dried overnight and of rapid panels with positive aerobic blood cultures obtained from the BacT/Alert to determine antimicrobial susceptibilities. Inocula were limited to specimens that appeared unimicrobic on Gram stain. Results were compared to those obtained from panels inoculated following subculture. For 133 gram-negative bacilli, there were 94.7 and 93.5% categorical agreements between direct and standard methods for all drugs tested with overnight and rapid panels, respectively. For 104 gram-positive cocci, there were 93.2 and 93.1% categorical agreements for overnight and rapid panels, respectively. The major error (false resistance) rate for gram negatives was 1.4% for overnight versus 0.7% for rapid panels. The very major error (false susceptibility) rate was 2.7% for overnight versus 8.1% for rapid panels. The total error rates were 1.6% for overnight panels and 1.5% for rapid panels. The major error rates for gram-positive direct susceptibility tests were 2.6% for overnight and 2.5% for rapid panels. The very major error rates were 8.8 and 7.2% for overnight and rapid panels, respectively. Total error rates were 3.6% for overnight and rapid gram-positive panels. These findings suggest that susceptibility results obtained from directly inoculated gram-negative overnight panels have the greatest correlation to those obtained by standard methods. When discrepant results occur with direct-susceptibility testing, they are more likely to show false susceptibility than false resistance.

* Corresponding author. Mailing address: Department of Pathology, WP 230, University of Alabama at Birmingham, Birmingham, AL 35233. Phone: (205) 934-6421. Fax: (205) 975-4468. E-mail: Waites{at}path.uab.edu.

Journal of Clinical Microbiology, July 1998, p. 2052-2056, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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