Evaluation of the Accelerate Pheno System: Results from Two Academic Medical Centers

• Published in: Journal of clinical microbiology 2018-04, Vol.56 (4)
• Main Authors: Lutgring, Joseph D, Bittencourt, Cassiana, McElvania TeKippe, Erin, Cavuoti, Dominick, Hollaway, Rita, Burd, Eileen M
• Format: Article
• Language: English
• Subjects: Academic Medical Centers - statistics & numerical data; Anti-Bacterial Agents - therapeutic use; Bacteremia - diagnosis; Bacteremia - drug therapy; Bacteremia - microbiology; Bacteriology; Blood Culture - instrumentation; Blood Culture - methods; Blood Culture - statistics & numerical data; Data Accuracy; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - blood; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - drug therapy; Gram-Negative Bacterial Infections - microbiology; Gram-Positive Bacteria - isolation & purification; Gram-Positive Bacterial Infections - blood; Gram-Positive Bacterial Infections - diagnosis; Gram-Positive Bacterial Infections - drug therapy; Humans; Microbial Sensitivity Tests; Reagent Kits, Diagnostic; Sensitivity and Specificity; Time Factors
• ISSN: 0095-1137; 1098-660X
• DOI: 10.1128/JCM.01672-17

Rapid diagnostic tests are needed to improve patient care and to combat the problem of antimicrobial resistance. The Accelerate Pheno system (Accelerate Diagnostics, Tucson, AZ) is a new diagnostic device that can provide rapid bacterial identification and antimicrobial susceptibility test (AST) results directly from a positive blood culture. The device was compared to the standard of care at two academic medical centers. There were 298 blood cultures included in the study, and the Accelerate Pheno system provided a definitive identification result in 218 instances (73.2%). The Accelerate Pheno system provided a definitive and correct result for 173 runs (58.1%). The Accelerate Pheno system demonstrated an overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 94.7%, 98.9%, 83.7%, and 99.7%, respectively. An AST result was available for analysis in 146 instances. The overall category agreement was 94.1% with 12 very major errors, 5 major errors, and 55 minor errors. After a discrepancy analysis, there were 5 very major errors and 4 major errors. The Accelerate Pheno system provided an identification result in 1.4 h and an AST result in 6.6 h; the identification and AST results were 41.5 h and 48.4 h faster than those with the standard of care, respectively. This study demonstrated that the Accelerate Pheno system is able to provide fast and accurate organism identification and AST data. A limitation is the frequency with which cultures required the use of alternative identification and AST methods.