The volatile organic compounds detection in MDR Gram-negatives antimicrobial susceptibility testing: Results from a four-month laboratory experience

• Published in: Diagnostic microbiology and infectious disease 2024-12, Vol.110 (4), p.116533, Article 116533
• Main Authors: Calvo, Maddalena, Maugeri, Gaetano, Migliorisi, Giuseppe, Scalia, Guido, Stefani, Stefania
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - pharmacology; Drug Resistance, Multiple, Bacterial; Gram-Negative Bacteria - drug effects; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - microbiology; Humans; Microbial Sensitivity Tests - methods; Rapid sepsis diagnosis; Sensor arrays; VOCs detection; Volatile Organic Compounds - analysis; Volatile Organic Compounds - pharmacology
• ISSN: 0732-8893; 1879-0070; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2024.116533

•The importance to rapidly provide a microbiological diagnosis in the case of severe infections.•The volatile organic compounds (VOCs) detection may be used to investigate bacterial susceptibility profiles.•A real-life laboratory experience demonstrated a 100 % essential agreement between VOCs detection though the VITEKⓇ REVEAL™ technology and the conventional turbidimetric methods.•The study results encourage the application of the method in high-risk epidemiological areas, confirming the effectiveness of VOC detection in monitoring multi-drug-resistant bacteria susceptibility profiles. Systemic bacterial infections represent a significant clinical challenge due to the increasing resistance rate towards antimicrobials. An essential key to controlling antimicrobial resistance spread is to administer targeted therapy after a precise minimum inhibitory concentration reporting. Among the available fast technologies for antimicrobial susceptibility testing (AST), the VITEKⓇ REVEAL™ (Biomerieux, Florence, Italy) proposes volatile organic compounds (VOC) colourimetric arrays to discriminate between susceptible and resistant Gram-negative isolates directly from positive blood cultures. We evaluated this methodology during a four-month laboratory experience on 40 positive blood culture samples, reporting a comparison to standard culture-based methods. The protocol revealed an essential agreement of 100 % between the conventional and the experimental procedures, while the categorical agreement resulted in 97.5 % due to one very major error (VME) for meropenem/vaborbactam in K. pneumoniae. Although further studies will be necessary to investigate its performance on rare microorganisms, the VITEKⓇ REVEAL™ demonstrated an optimal sensitivity in defining MIC values for multi-drug resistant (MDR) microorganisms. These results encourage the application of the method in all high-risk epidemiological areas, confirming the effectiveness of VOC detection in monitoring bacterial susceptibility profiles.