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59 protocols using phoenix 100

1

Bacterial Identification and Antimicrobial Profiles

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Bacterial isolation, species identi cation and antimicrobial susceptibility pro les Identi cation of strains was performed by using BD Phoenix-100 (BD, American) and 16S rRNA gene sequencing. Antimicrobial susceptibilities were initially tested using BD Phoenix-100 (BD, American), following which MICs were measured using broth microdilutions according to the Clinical and Laboratory Standards Institute (CLSI) guidelines [14] . Escherichia coli (E. coli) strain ATCC 25922 was used as the quality control. The CLSI breakpoints (M100-S27) and the 2018 EUCAST breakpoints (only for polymyxin and tigecycline) were used to interpret the MIC results.
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Bacterial Strain Identification and Antimicrobial Susceptibility

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Identification of strains was performed by using BD Phoenix-100 (BD, American) and 16S rRNA gene sequencing. Antimicrobial susceptibilities were initially tested using BD Phoenix-100 (BD, American), following which MICs were measured using broth microdilutions according to the Clinical and Laboratory Standards Institute (CLSI) guidelines [14] . Escherichia coli (E. coli) strain ATCC 25922 was used as the quality control. The CLSI breakpoints (M100-S27) and the 2018 EUCAST breakpoints (only for polymyxin and tigecycline) were used to interpret the MIC results.
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3

Rapid Microbial Identification and Resistance Detection

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BCs were processed as previously described15 (link). Positive BCs were defined according to Weinstein 8 (link). Coagulase-negative staphylococci, aerobic and anaerobic diphtheroids, Micrococcus spp., Bacillus spp., and viridans streptococci were considered contaminants if only one bottle was positive, and susceptibility testing was not performed.
An alert system was implemented in case of positive BCs that consisted of a phone call to the ward in charge of the patient and e-mail was automatically sent to the ID consultant physicians.
The organisms are identified through Gram stain on smears and by Matrix-Assisted Laser Desorption Ionization time-of-flight (MALDI-TOF) (Bruker Daltonics GmbH, Bremen, Germany) or by biochemical tests using Phoenix 100 (BD) automated system N-MIC/ID or P-MIC/ID panel GmbH, Bremen, Germany). The antimicrobial susceptibility is tested using Phoenix 100 (BD).A real-time PCR technology GeneXpert system (Cepheid, Sunnyvale, CA), performed according to the manufacturer's instructions, is used to detect methicillin/oxacillin resistance for BCs growing Gram-positive (GP). A multiplex nested PCR FilmArray enables rapid (1 h) and accurate detection of 24 pathogens (bacteria and yeasts) and 3 antibiotic resistance genes and rapid immune-chromatographic tests are used for the determination of resistance markers.
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4

Comparative Evaluation of Automated CRE Detection

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All the CRE isolates were tested duplicatelyin parallel on three automated identification systems. The three systems were: MicroScan WalkAway 96 Plus (SIEMENS AG FWB, Germany) with NC 50 cards for testing imipenem, meropenem and ertapenem; Phoenix 100 (Becton, Dickinson and Company, USA) with NMIC/ID-4 panels for testing imipenem and meropenem; and Vitek-2 Compact (Bio Mérieux, France) with AST-GN and AST-GN16 cards for testing imipenem and ertapenem simultaneously;. All the assays were accomplished in the Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, China. The carbapenemase-producing Enterobacteriaceae (CPE) were predicted by the advanced expert system (AES) of the automated systems. The susceptibility breakpoints of the three commercial systems were interpreted as recommended by the Clinical and Laboratory Standards Institute (CLSI) [16 ]. To identify CRE, the comparator methodology was agar dilution method, while the PCR and sequencing was the comparator one to identify CPE.
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5

Bacterial Identification and Gastrointestinal Infection Screening

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A single strain was derived from the first sample collected in the case of the first episode of HAI, and to confirm a diagnosis of BSI, at least two blood samples were taken. The strains were identified using BD Phoenix NID panels from the automated Phoenix 100 Becton Dickinson Diagnostic System (Becton Dickinson, Warsaw, Poland) according to the manufacturer’s instructions. All materials taken from gastrointestinal tract infections were tested for Shigella spp., Salmonella spp., rotavirus, norovirus, adenovirus, and Clostridium difficile (CD), and a general stool culture was performed.
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6

Isolation and Preparation of S. aureus for IAOM Mice

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S. aureus was isolated from a patient with chronic osteomyelitis, and methicillin-sensitive S. aureus was identified using PHOENIX 100 (Becton, Dickinson Microbiology Systems, USA). A frozen stock of S. aureus strains was routinely grown on tryptic soy broth (TSB) with shaking at 180 rpm at 37°C for 16 h and collected by centrifugation at 3,000 rpm for 10 min. The bacterial pellets were washed and resuspended in phosphate-buffered saline (PBS). The concentration of S. aureus was adjusted to an optical density (OD) of 0.5 at 600 nm, approximately equal to 1 × 108 CFU/ml, and further adjusted to 1 × 105 CFU/ml for soaking implants for IAOM mice.
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Antibiotic Susceptibility Testing Comparison

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Aminoglycosides (gentamicin and amikacin) and fluoroquinolones (ciprofloxacin and levofloxacin) susceptibility tests were conducted simultaneously following the manufacturers’ instructions using the three different automated systems: MicroScan WalkAway 96 Plus (SIEMENS AG FWB, Germany) with NC 50 cards, Phoenix 100 (Becton, Dickinson and Company, USA) with NMIC/ID-4 panels and Vitek-2 Compact (Bio Mérieux, France) with AST-GN16 cards. All the assays were accomplished in the research laboratory of Fujian Medical University Union Hospital, China. The susceptibility breakpoints of the three commercial systems were interpreted as recommended by the Clinical and Laboratory Standards Institute(CLSI) [15 ]. Reference MIC values for the tested isolates were determined by agar dilution method with Mueller-Hinton agar according to CLSI guidelines [15 ]. E. coli ATCC25922 was used as quality control strain.
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8

Bacterial Identification and Antibiotic Susceptibility

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Bacterial species identification and antimicrobial susceptibility testing were performed using the Phoenix100 automated system according to the manufacturer’s recommendations (Becton Dickinson Co., Sparks, MD, USA). The identification of Salmonella spp. was based on a serum agglutination test. The polymyxin B MICs of the isolates were determined by broth microdilution. The results were interpreted using the clinical breakpoints of the European Committee on Antimicrobial Susceptibility Testing.19 Isolates with an MIC higher than 2 mg/L for polymyxin B were considered PR. Escherichia coli ATCC 25922 and Escherichia coli NCTC 13846 (mcr-1-positive) were used as quality control strains.
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9

Methicillin-resistant Staphylococcus aureus Isolation

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A total of 70 S. aureus strains: 38 (54%) MRSA and 32 (46%) MSSA were isolated from clinical samples obtained from the patients. The strains were stored at −80 °C until use. Identification and antibiotics-susceptibility testing were performed with PHOENIX 100 (Becton Dickinson, Franklin Lakes, NJ) and methicillin resistance of strains was confirmed by the cefoxitin disk diffusion test (Oxoid, Hampshire, England), based on recommendations of the Clinical Laboratory Standards Institute. For quality control, reference strains ATCC 43300 and ATCC 29213 and a PVL+ strain were used in the study.
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10

Microbial Culture and Antimicrobial Susceptibility

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Microbiological cultures of the bile and drainage fluid were performed by conventional methods. In vitro antimicrobial susceptibility of isolated organisms was done in a local microbiology laboratory using the Phoenix 100 automated system (Becton Dickinson, Spark, MD, USA) according to EUCAST interpretation criteria.
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