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FAST: Rapid determinations of antibiotic susceptibility phenotypes using label‐free cytometry
Author(s) -
Huang TzuHsueh,
Tzeng YihLing,
Dickson Robert M.
Publication year - 2018
Publication title -
cytometry part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.316
H-Index - 90
eISSN - 1552-4930
pISSN - 1552-4922
DOI - 10.1002/cyto.a.23370
Subject(s) - bacteremia , antibiotics , sepsis , blood culture , klebsiella pneumoniae , microbiology and biotechnology , antibiotic resistance , flow cytometry , colony forming unit , cytometry , medicine , biology , multidrug tolerance , acinetobacter baumannii , bacteria , escherichia coli , immunology , pseudomonas aeruginosa , genetics , biochemistry , gene , biofilm
Sepsis, a life‐threatening immune response to blood infections (bacteremia), has a ∼30% mortality rate and is the 10th leading cause of US hospital deaths. The typical bacterial loads in adult septic patients are ≤100 bacterial cells (colony forming units, CFU) per ml blood, while pediatric patients exhibit only ∼1000 CFU/ml. Due to the low numbers, bacteria must be propagated through ∼24‐hours blood cultures to generate sufficient CFUs for diagnosis and further analyses. Herein, we demonstrate that, unlike other rapid post‐blood culture antibiotic susceptibility tests (ASTs), our phenotypic approach can drastically accelerate ASTs for the most common sepsis‐causing gram‐negative pathogens by circumventing long blood culture‐based amplification. For all blood isolates of multi‐drug resistant pathogens investigated ( Escherichia coli, Klebsiella pneumoniae, and Acinetobacter nosocomialis ), effective antibiotic(s) were readily identified within the equivalent of 8 hours from initial blood draw using <0.5 mL of adult blood per antibiotic. These methods should drastically improve patient outcomes by significantly reducing time to actionable treatment information and reduce the incidence of antibiotic resistance. © 2018 International Society for Advancement of Cytometry