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

<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>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™ system (Accelerate Diagnostics, Inc.) provides information on pathogen identification and antibiotic susceptibility in approximately 1.5 and 7 hours, respectively.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In this study we compared the Accelerate Pheno™ system with the standard procedure used in our laboratory. A total of 41 blood cultures were prospectively analysed with the Accelerate Pheno™ 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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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 Pheno™ system. The mean (sd) time of AST with the BD Phoenix system was 15.85 (2.57) hours and with the Accelerate Pheno™ 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™ system were observed particularly for <jats:italic>P. aeruginosa.</jats:italic></jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The Accelerate Pheno™ system can improve turn-around time in the management of patients with bloodstream infections.</jats:p></jats:sec>