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Bacteriology

Two-Center Collaborative Evaluation of Performance of the BD Phoenix Automated Microbiology System for Identification and Antimicrobial Susceptibility Testing of Gram-Negative Bacteria

Maria Grazia Menozzi, Ulrich Eigner, Silvia Covan, Sabina Rossi, Pietro Somenzi, Giuseppe Dettori, Carlo Chezzi, Anne-Marie Fahr
Maria Grazia Menozzi
1Section of Microbiology, Department of Pathology and Laboratory Medicine, University of Parma, I-43100 Parma, Italy
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  • For correspondence: mariagrazia.menozzi@unipr.it
Ulrich Eigner
2Department of Microbiology, Laboratory Group Heidelberg, D-69126 Heidelberg, Germany
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Silvia Covan
1Section of Microbiology, Department of Pathology and Laboratory Medicine, University of Parma, I-43100 Parma, Italy
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Sabina Rossi
1Section of Microbiology, Department of Pathology and Laboratory Medicine, University of Parma, I-43100 Parma, Italy
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Pietro Somenzi
1Section of Microbiology, Department of Pathology and Laboratory Medicine, University of Parma, I-43100 Parma, Italy
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Giuseppe Dettori
1Section of Microbiology, Department of Pathology and Laboratory Medicine, University of Parma, I-43100 Parma, Italy
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Carlo Chezzi
1Section of Microbiology, Department of Pathology and Laboratory Medicine, University of Parma, I-43100 Parma, Italy
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Anne-Marie Fahr
2Department of Microbiology, Laboratory Group Heidelberg, D-69126 Heidelberg, Germany
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DOI: 10.1128/JCM.00614-06
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Tables

  • TABLE 1.

    ID results for gram-negative bacilli

    GroupNo. testedNo. (%) of ID results:Phoenix ID (n = 1)Comparator system ID
    SpeciesIsolatesConcordantDiscordantNo IDATBVITEK 2
    Enterobacteriaceae 27384378 (98.4)5 (1.3)1 (0.3) Escherichia coli C. freundii C. freundii
    Citrobacter freundii E. cloacae E. cloacae
    Enterobacter cloacae K. oxytoca K. oxytoca
    Morganella morganii P. stuartii a No ID
    Shigella boydii E. coli a No ID
    No ID C. freundii C. freundii
    Nonfermentersb11110109 (99.1)1 (0.9) Pasteurella multocida B. cepacia a No ID
    Total38494487 (98.6)6 (1.2)1 (0.2)
    • ↵ a ATB ID had an unacceptable profile or insufficient discrimination.

    • ↵ b Including one fermentative oxidase-positive strain of Aeromonas sp.

  • TABLE 2.

    Susceptibility test results for Enterobacteriaceae and nonfermenters from Heidelberg and Parma

    Group and centerNo. of isolates testedNo. of single testsNo. of single test results in interpretive category% of results with:
    IREACAmEMEVME
    Enterobacteriaceae
        Parma22410,3304192,86395.098.21.40.11.7
        Heidelberg1607,4743111,68393.997.01.40.81.8
        Total38417,8047304,54694.497.61.70.51.8
    Nonfermentersa
        Parma731,97218697196.997.81.70.70.6
        Heidelberg3797112730888.092.35.63.01.6
        Total1102,9433131,27993.295.53.31.70.9
    All
        Parma29712,3026053,83495.498.11.40.21.4
        Heidelberg1978,4454381,99193.296.52.41.01.8
        Total49420,7471,0435,82594.297.31.90.61.6
    • ↵ a Including one fermentative oxidase-positive strain of Aeromonas sp.

  • TABLE 3.

    Susceptibility test results for Enterobacteriaceae

    DrugNo. of isolatesBreakpoint standardNo. of isolates in interpretive category% of results with:
    SIREACAmEMEVME
    Quinolones
        Ciprofloxacin382NCCLS320144899.299.50.50.00.0
        Gatifloxacin382NCCLS328134197.999.01.00.00.0
        Levofloxacin382NCCLS332123899.299.70.30.00.0
        Lomefloxacin382NCCLS305185999.299.20.80.00.0
        Moxifloxacin370Pharma307164796.299.20.80.00.0
        Norfloxacin381NCCLS325164098.499.70.30.00.0
        Ofloxacin382NCCLS321134899.299.70.30.00.0
        Nalidixic acid379NCCLS27710296.0100.00.00.00.0
    Aminoglycosides
        Amikacin382NCCLS3726494.099.50.50.00.0
        Gentamicin382NCCLS328104497.4100.00.00.00.0
        Kanamycin363NCCLS29766097.0100.00.00.00.0
        Netilmicin381NCCLS34582895.399.01.00.00.0
        Tobramycin382NCCLS323184196.399.20.80.00.0
    β-Lactam penicillins
        Ampicillin382NCCLS741129791.293.24.26.81.7
        Piperacillin383NCCLS2062914886.292.76.51.50.0
        Ticarcillin383NCCLS1392122391.996.32.91.40.4
    β-Lactam/β-lactamase inhibitors
        Amoxicillin/clavulanate382NCCLS1862417295.296.62.41.11.2
        Ampicillin/sulbactam382NCCLS1465817890.691.66.32.12.8
        Piperacillin/tazobactam381NCCLS286128390.496.32.90.32.4
    Carbapenems
        Imipenem379NCCLS36113587.698.71.30.00.0
        Meropenem377NCCLS3731396.099.50.50.00.0
    Cephems
        Cefazolin379NCCLS1671220093.394.72.91.23.5
        Cefdinir382NCCLS2081515989.793.23.93.42.5
        Cefepime381NCCLS32525492.798.70.30.63.7
        Cefmetazole324NCCLS222129092.295.72.21.44.4
        Cefoperazone379NCCLS257611691.596.62.11.60.9
        Cefotaxime380NCCLS295117496.497.61.80.02.7
        Cefotetan381NCCLS29168493.196.61.80.07.1
        Cefoxitin382NCCLS2192413992.796.12.41.42.2
        Cefpodoxime378NCCLS2412711089.394.44.20.04.5
        Ceftazidime382NCCLS29857995.898.71.00.01.3
        Ceftibuten371NCCLS28238689.497.31.90.42.3
        Ceftizoxime377NCCLS29148297.298.70.50.71.2
        Ceftriaxone382NCCLS290128094.996.12.60.35.0
        Cefuroxime381NCCLS2132214694.297.41.01.91.4
        Cephalothin381NCCLS1054423295.497.90.81.01.7
    Monobactams
        Aztreonam382NCCLS29967797.397.91.00.33.9
    Folate antagonists
        Trimethoprim382NCCLS2909291.999.00.00.04.3
        Trimethoprim/sulfamethoxazole382NCCLS2998397.197.60.01.74.8
    Others
        Tetracycline379NCCLS2172613694.597.91.60.50.7
        Chloramphenicol382NCCLS297176894.596.62.61.00.0
        Nitrofurantoin377NCCLS197978396.698.11.60.50.0
    • ↵ a Pharm, pharmaceutical company.

  • TABLE 4.

    Susceptibility test results for Pseudomonas spp.a

    DrugNo. of isolatesNo. of isolates in interpretive category% of results with:
    SIREACAmEMEVME
    Fluoroquinolones
        Ciprofloxacin785342197.498.71.30.00.0
        Levofloxacin744742391.996.04.10.00.0
        Lomefloxacin7837113096.298.71.30.00.0
        Norfloxacin785361996.297.42.60.00.0
        Ofloxacin774552797.498.71.30.00.0
    Aminoglycosides
        Amikacin79691991.196.22.50.011.1
        Gentamicin7953917100.0100.00.00.00.0
        Netilmicin785761598.7100.00.00.00.0
        Tobramycin79621797.5100.00.00.00.0
    β-Lactam penicillins
        Piperacillin79572292.396.20.01.89.1
        Ticarcillin79562393.798.70.01.80.0
    β-Lactam/β-lactamase inhibitors
        Piperacillin/tazobactam79611892.397.50.00.011.1
    Carbapenems
        Imipenem776061193.594.85.20.00.0
        Meropenem77677390.998.71.30.00.0
    Cephems
        Cefepime785514991.097.42.60.00.0
        Cefoperazone7846102296.296.22.62.20.0
        Cefotaxime795383691.191.17.620.00.0
        Ceftazidime775871294.897.42.60.00.0
        Ceftizoxime783255091.091.07.733.30.0
        Ceftriaxone7917293387.388.610.15.90.0
    Monobactams
        Aztreonam785181991.091.07.72.00.0
    • ↵ a The NCCLS breakpoint standard was used for each drug.

  • TABLE 5.

    Susceptibility test results for nonfermentative bacteria other than Pseudomonas spp.a

    DrugNo. of isolatesNo. of isolates in interpretive category:% of results with:
    SIREACAmEMEVME
    Fluoroquinolones
        Ciprofloxacin30831996.7100.00.00.00.0
        Levofloxacin301511490.096.73.30.00.0
        Lomefloxacin309516100.0100.00.00.00.0
        Norfloxacin30622296.7100.00.00.00.0
        Ofloxacin291141496.696.63.50.00.0
    Aminoglycosides
        Amikacin29121789.789.76.90.05.9
        Gentamicin30812196.796.73.30.00.0
        Netilmicin30812196.796.70.00.04.8
        Tobramycin30812193.396.70.00.04.8
    β-Lactam penicillins
        Piperacillin30671773.376.723.30.00.0
        Ticarcillin30481873.376.720.025.00.0
    β-Lactam-β-lactamase inhibitors
        Ampicillin/sulbactam30442293.393.36.70.00.0
        Piperacillin/tazobactam301061476.780.016.710.00.0
    Carbapenems
        Imipenem30111996.7100.00.00.00.0
        Meropenem291211696.696.63.50.00.0
    Cephems
        Cefepime301051573.393.36.00.00.0
        Cefoperazone30822093.393.33.312.50.0
        Cefotaxime305322100.0100.00.00.00.0
        Ceftazidime291131582.782.813.89.10.0
        Ceftizoxime30532296.796.70.00.04.6
        Ceftriaxone30622290.096.73.30.00.0
    Monobactams
        Aztreonam30442296.796.70.025.00.0
    Folate antagonists
        Trimethoprim/sulfamethoxazole30171390.093.30.011.80.0
    Others
        Tetracycline309615100.0100.00.00.00.0
        Chloramphenicol301321596.796.70.07.70.0
    • ↵ a Genera included Achromobacter, Acinetobacter, Alcaligenes, Burkholderia, Stenotrophomonas, and one fermentative oxidase-positive strain of Aeromonas sp. The NCCLS breakpoint was used for each drug.

  • TABLE 6.

    ESBL results for the E. coli and Klebsiella isolates tested in this study

    Isolate type and speciesNo. of resultsa:Result (%) forb:
    Total+ by both testsPHX+ and REF−PHX− and REF+− by both testsSensitivitySpecificityPPVNPVAgreement
    Clinical
        E. coli7160065100100100100100
        K. pneumoniae4970042100100100100100
        K. oxytoca275102110095.583.310096.3
    Challenge
        E. coli3112111792.394.492.394.493.5
        K. pneumoniae2017003100100100100100
        K. oxytoca53002100100100100100
    Clinical and challenge
        E. coli10218118294.798.894.798.898.0
        K. pneumoniae69240045100100100100100
        K. oxytoca328102310095.888.910096.9
    Total203502115098.098.796.299.398.5
    • ↵ a PHX, Phoenix system; REF, reference method. +, positive; −, negative.

    • ↵ b PPV, positive predictive value; NPV, negative predictive value.

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Two-Center Collaborative Evaluation of Performance of the BD Phoenix Automated Microbiology System for Identification and Antimicrobial Susceptibility Testing of Gram-Negative Bacteria
Maria Grazia Menozzi, Ulrich Eigner, Silvia Covan, Sabina Rossi, Pietro Somenzi, Giuseppe Dettori, Carlo Chezzi, Anne-Marie Fahr
Journal of Clinical Microbiology Nov 2006, 44 (11) 4085-4094; DOI: 10.1128/JCM.00614-06

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Two-Center Collaborative Evaluation of Performance of the BD Phoenix Automated Microbiology System for Identification and Antimicrobial Susceptibility Testing of Gram-Negative Bacteria
Maria Grazia Menozzi, Ulrich Eigner, Silvia Covan, Sabina Rossi, Pietro Somenzi, Giuseppe Dettori, Carlo Chezzi, Anne-Marie Fahr
Journal of Clinical Microbiology Nov 2006, 44 (11) 4085-4094; DOI: 10.1128/JCM.00614-06
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KEYWORDS

bacteriological techniques
Gram-negative bacteria
Microbial Sensitivity Tests

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