PMID- 34011524
OWN - NLM
STAT- MEDLINE
DCOM- 20211022
LR  - 20220524
IS  - 1098-660X (Electronic)
IS  - 0095-1137 (Print)
IS  - 0095-1137 (Linking)
VI  - 59
IP  - 9
DP  - 2021 Aug 18
TI  - Evaluation of the Vitek 2, Phoenix, and MicroScan for Antimicrobial 
      Susceptibility Testing of Stenotrophomonas maltophilia.
PG  - e0065421
LID - 10.1128/JCM.00654-21 [doi]
LID - e00654-21
AB  - Stenotrophomonas maltophilia causes high-mortality infections in 
      immunocompromised hosts with limited therapeutic options. Many U.S. laboratories 
      rely on commercial automated antimicrobial susceptibility tests (cASTs) and use 
      CLSI breakpoints (BPs) for S. maltophilia. However, contemporary data on these 
      systems are lacking. We assessed performance of Vitek 2, MicroScan WalkAway, and 
      Phoenix relative to that of reference broth microdilution for 
      trimethoprim-sulfamethoxazole (SXT), levofloxacin (LEV), minocycline (MIN), and 
      ceftazidime (CAZ) with 109 S. maltophilia bloodstream isolates. Using CLSI 
      breakpoints, categorical agreement (CA) was below 90% on all systems and drugs, 
      with the exception of SXT by MicroScan (98.1%) and Phoenix (98.1%) and MIN by 
      MicroScan (100%) and Phoenix (99.1%). For SXT, Vitek 2 yielded a 77.1% CA. LEV 
      and CAZ CA ranged from 67% to 85%. Very major errors (VME) were >3% for SXT 
      (MicroScan, Phoenix), LEV (MicroScan), and CAZ (all systems). Major errors (ME) 
      were >3% for SXT (Vitek 2), LEV (Phoenix), and CAZ (MicroScan, Phoenix). Minor 
      errors were >10% for CAZ and LEV on all systems. Data were analyzed with EUCAST 
      pharmacokinetic/pharmacodynamic CAZ, LEV, ciprofloxacin (CIP), and tigecycline 
      (TGC) breakpoints when possible. CA was <90% for all. VME were >3% for CAZ (all 
      systems), LEV (MicroScan), and TGC (Vitek 2), and ME were >3% for LEV 
      (MicroScan), CAZ (all systems), ciprofloxacin (Vitek 2 and MicroScan), and TGC 
      (Vitek 2, Phoenix). Minor errors (MI) were >10% for all agents and systems, by 
      EUCAST breakpoints with an intermediate category (LEV, CAZ, CIP). Laboratories 
      should use caution with cASTs for S. maltophilia, as a high rate of errors may be 
      observed.
FAU - Khan, Ayesha
AU  - Khan A
AD  - Center for Antimicrobial Resistance and Microbial Genomics, UTHealth, Houston, 
      Texas, USA.
AD  - Division of Infectious Diseases, McGovern Medical School, UTHealth, Houston, 
      Texas, USA.
FAU - Arias, Cesar A
AU  - Arias CA
AD  - Center for Antimicrobial Resistance and Microbial Genomics, UTHealth, Houston, 
      Texas, USA.
AD  - Division of Infectious Diseases, McGovern Medical School, UTHealth, Houston, 
      Texas, USA.
AD  - Center for Infectious Diseases, University of Texas Health Science Center, School 
      of Public Health, Houston, Texas, USA.
AD  - Molecular Genetics and Antimicrobial Resistance Unit, International Center for 
      Microbial Genomics, Universidad El Bosque, Bogota, Colombia.
FAU - Abbott, April
AU  - Abbott A
AD  - Deaconess Health System, Indiana University Medical School, Evansville, Indiana, 
      USA.
FAU - Dien Bard, Jennifer
AU  - Dien Bard J
AD  - Department of Pathology and Laboratory Medicine, Children's Hospital of Los 
      Angeles, Keck school of Medicine, University of Southern California, Los Angeles, 
      California, USA.
FAU - Bhatti, Micah M
AU  - Bhatti MM
AD  - Department of Pathology and Laboratory Medicine, MD Anderson Cancer Center, 
      Houston, Texas, USA.
FAU - Humphries, Romney M
AU  - Humphries RM
AD  - Department of Pathology, Microbiology and Immunology, Vanderbilt University 
      Medical Center, Nashville, Tennessee, USA.
LA  - eng
GR  - K24 AI121296/AI/NIAID NIH HHS/United States
GR  - P01 AI152999/AI/NIAID NIH HHS/United States
GR  - R01 AI134637/AI/NIAID NIH HHS/United States
PT  - Journal Article
DEP - 20210818
PL  - United States
TA  - J Clin Microbiol
JT  - Journal of clinical microbiology
JID - 7505564
RN  - 0 (Anti-Bacterial Agents)
RN  - 70JE2N95KR (Tigecycline)
RN  - 9M416Z9QNR (Ceftazidime)
SB  - IM
CIN - J Clin Microbiol. 59.
MH  - Anti-Bacterial Agents/pharmacology
MH  - Ceftazidime
MH  - Humans
MH  - Microbial Sensitivity Tests
MH  - *Stenotrophomonas maltophilia
MH  - Tigecycline
PMC - PMC8373028
OTO - NOTNLM
OT  - Stenotrophomonas
OT  - antimicrobial activity
OT  - antimicrobial agents
OT  - assay standardization
OT  - automation
OT  - bloodstream infections
OT  - breakpoints
OT  - diagnostics
OT  - immunocompromised hosts
OT  - susceptibility testing
EDAT- 2021/05/21 06:00
MHDA- 2021/12/07 06:00
PMCR- 2022/02/18
CRDT- 2021/05/20 05:46
PHST- 2021/05/21 06:00 [pubmed]
PHST- 2021/12/07 06:00 [medline]
PHST- 2021/05/20 05:46 [entrez]
PHST- 2022/02/18 00:00 [pmc-release]
AID - JCM.00654-21 [pii]
AID - 00654-21 [pii]
AID - 10.1128/JCM.00654-21 [doi]
PST - ppublish
SO  - J Clin Microbiol. 2021 Aug 18;59(9):e0065421. doi: 10.1128/JCM.00654-21. Epub 
      2021 Aug 18.