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352 protocols using vitek 2 compact

1

Isolation and Identification of Foodborne Pathogens

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Tubes containing swabs and BPW were gently mixed. For isolation of E. coli and Staphylococcus spp., 100 μL from each tube was streaked onto each of MacConkey, Sorbitol MacConkey, and Baird-Parker (Oxoid, UK), then incubated at 37 °C for 24 h. Lactose fermenting colonies on MacConkey agar, white colonies on Sorbitol MacConkey agar, and black colonies on Baird–Parker agar were identified biochemically to species level by VITEK® 2 COMPACT (BioMérieux, France). For isolation of Salmonella, tubes containing BPW were enriched overnight aerobically at 37 °C, then incubated on Rappaport-Vassiliadis broth (Oxoid, UK) at 42 °C in aerobic conditions for 24 h, before inoculation on to xylose lysine deoxycholate agar (Oxoid, UK) and incubated under aerobic conditions at 37 °C for 24 h. Suspected colonies were identified biochemically by VITEK® 2 COMPACT (BioMérieux, France). Biochemically identified Salmonella isolates have been serologically confirmed on the basis of somatic (O) and flagellar (H) antigens by slide agglutination using commercial antisera (SISIN, Germany) following the Kauffman–White scheme [53 (link)].
For molecular conformation, bacterial DNA was extracted from biochemically identified E. coli, Salmonella, and Staphylococcus isolates for amplification and sequencing of 16S rRNA gene according to Lane [54 ] and Weisberg et al. [55 (link)].
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2

Bacterial Identification and Antibiotic Susceptibility

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Sample processing followed the hospital’s protocol, using specific media: sheep blood agar (bioMérieux, Marcy–l’ Étoile, France), Brilliance™ UTI Agar (Thermo Fisher Scientific, Waltham MA, USA). The strains were identified to the species level using a Vitek® 2 Compact (bioMérieux, Marcy–l’ Étoile, France) GP card and with the antibiotic susceptibility performed using Vitek® 2 Compact (bioMérieux, Marcy–l’ Étoile, France) AST P592 card.
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3

Identifying Antibiotic-Resistant Microbes

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Colonies obtained in each processed plate were screened by their resistances, using broad spectrum antibiotics-10 μg ampicillin, 4 μg gentamicin and 5 μg chloramphenicol (Britania SA, Argentina) placed separately on Muller–Hinton agar plates and incubated aerobically at 37°C for 18 hours. The number of colony forming units (CFU) for the sample pool was estimated by plaque count.
Isolated microorganisms were identified using Gram stain, colony morphology, standard biochemical tests and confirmed by the automated ID/AST instrument Vitek® 2 Compact (Biomerieux) both Gram positive (GP ID card) and Gram negative (GN ID card) cards (Biomerieux, France) were used. Minimal inhibitory concentration (MIC) was performed using the automated ID/AST instrument Vitek® 2 Compact (Biomerieux) and the Gram positive and Gram negative susceptibility test cards (AST-P577; AST-N117; Biomerieux, France). Diffusion method according to Kirby-Bauer was used for the antibiotics aztreonam, minocycline and levofloxacin. The breakpoints were interpreted following CLSI guidelines [7 ].
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4

Identification and Antimicrobial Susceptibility of Acinetobacter baumannii Complex

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During the study period, blood specimens were obtained under sterile conditions and cultured using the BacT/Alert 3D blood culture system (bioMerieux, Durham, USA). Identification of microorganisms was conducted using the VITEK 2 compact (bioMerieux, Durham, USA), and A. baumannii complex described here included the following 4 species: A. baumannii, A. nosocomialis, A. pittii, and A. calcoaceticus, which cannot been distinguished by conventional biochemical methods [14 (link),15 (link)]. Susceptibility testing of Cefperazone/sulbactam was performed using the manual disk diffusion method. For other antimicrobials, susceptibility testing was conducted using the VITEK 2 compact (bioMerieux, Durham, USA). The susceptibility results were interpreted following the breakpoints defined by the most current Clinical and Laboratory Standards Institute [16 ]. Multidrug resistance was defined as non-susceptibility to 3 or more of the following groups of antimicrobials: aminoglycosides, anti-pseudomonal penicillins, carbapenems, cephalosporins, and quinolones [17 (link)].
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5

Diagnosis and Treatment of Liver Abscess

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Patients completed laboratory tests for indicators, such as routine blood parameters, CRP, albumin, transaminase, lactic acid, prothrombin time (PT) and international normalized ratio (INR), procalcitonin and blood culture within 48 h of admission, and completed abdominal ultrasound/CT/MRI examination within 1 week of admission. Patients who did not respond to initial treatment underwent ultrasound-guided percutaneous drainage (USPD) to drain the liver abscess. Pathogenic microorganisms in blood or abscess samples from patients with liver abscess were cultured and identified using a BD BACTEC FX400 automatic microbial blood culture system (Becton, Dickinson and Company; Franklin Lakes, NJ, USA) and the VITEK2 Compact automated microbial identification and antibiotic susceptibility testing instrument (bioMerieux; Marcy-l'Étoile, France), according to the manufacturers’ instructions. Bacterial drug sensitivity was determined by analysing the minimum inhibitory concentration using the identification and antibiotic susceptibility testing card (Vitek 2 Compact; bioMerieux). The selection of antibiotics and interpretation of drug sensitivity results was based on American Clinical and Laboratory Standards Institute recommendations.7 (link)
Results were analysed using WHONET software, version 5.6 (www.whonet.org).
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6

Bacterial Identification and Susceptibility

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Direct microscopy on the clinical samples was performed using 100 × immersion oil microscopy after staining the slides with Gram and methylene blue stain. The latter assists in the differentiation between colonization and infection, based on the presence of polymorphonuclear cells. Endotracheal specimens were cultured on blood-agar, eosin-methylene blue agar (Levin's medium) and thioglycolate broth. Semi-automated (API 20 NE, bioMerieux) and automated systems (Vitek-2 Compact, bioMerieux and MALDI-TOF MS, Vitek-MS, bioMerieux) were used for bacterial identification. Antimicrobial susceptibility testing was performed on Müller-Hinton agar by using the disk-diffusion method of Bauer-Kirby and by using E-test and broth microdilution test to determine the minimal inhibitory concentrations (MIC), as well as automated systems (Vitek-2 Compact, bioMerieux).
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7

Carbapenem-resistant Enterobacteriaceae Identification

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All the isolates were identi ed at the species level by semi-or automated systems, such as the VITEK2 compact (bioMérieux, Inc., Durham, NC) system, or the VITEK MS (bioMerieux, Hazelwood, MO, United States) automated system, and so on. Routine antimicrobial susceptibility testings were performed by using either the API system, the BD Phoenix System (Becton Dickinson, America), or the VITEK2 compact (bioMérieux, Inc., Durham, NC) system. According to the breakpoint recommendations by the Clinical and Laboratory Standards Institute, 2018 (CLSI-2018), K. pneumoniae or E. coli isolates which were resistant to at least one of the carbapenems, with the criteria of minimum inhibitory concentration (MIC) of ≥ 2µg/mL for ertapenem, ≥ 4 µg/mL for imipenem, or ≥ 4µg/mL for meropenem, were de ned as carbapenem-resistant Enterobacteriaceae (CRE); while carbapenemresistant A. baumannii (CRABA) or P. aeruginosa (CRPAE) strains were de ned as MIC≥8µg/mL for imipenem or meropenem.
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8

Screening for Multidrug-Resistant Organisms

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Blood cultures were collected using BACTEC liquid media bottles (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) and incubated on the BACTEC FX (Becton, Dickinson and Company) blood culture system. Positive blood cultures were subcultured on solid media for 16–24 hours, and identification and susceptibility testing were performed using VITEK2 Compact (bioMérieux, Marcy l’Etoile, France).
Perianal swabs were obtained for infection control purposes per institutional guidelines: at initial arrival at the institution, following infection with a resistant organism, and weekly while admitted to the inpatient transplant unit. Swabs were used to inoculate blood agar and MacConkey agar plates (Becton, Dickinson and Company) and 5 mL of trypticase soy broth (TSB; Becton, Dickinson and Company) containing a 10-µg meropenem disc (Becton, Dickinson and Company). After overnight incubation, the tripticase soy broth (TSB) was subcultured to the MacConkey agar plates. MacConkey culture and subculture plates were examined (at 24 and 48 hours) for the presence of lactose-fermenting Gram-negative bacilli. Isolated lactose-fermenting Gram-negative bacilli were identified and tested for the presence of extended-spectrum beta-lactamase (ESBL) and carbapenem resistance using the VITEK2 Compact (bioMérieux).
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9

Bacterial Culture and Antibiotic Susceptibility Testing

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Testing of the prepared PT matrix was conducted in two stages, namely testing by the researcher and testing by the participating laboratories. All samples were subjected to bacterial culture and, if positive, Gram staining, bacterial identification and AST were performed. Two approved and commonly used bacterial culture testing platforms, where bacterial strains metabolise the substrates of the culture media, were used, namely BacT/ALERT 3D (bioMérieux, Craponne, France) and BACTEC 9120 (Becton Dickinson, San Jose, California, United States), and Vitek II Compact (bioMérieux, Craponne, France) was used for AST.
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10

Gram-negative Bacteria Identification and Antibiotic Susceptibility

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Identification of Gram-negative bacteria species was done by the VITEK-II-COMPACT instrument (BioMerieux, France). These isolates were tested for antimicrobial susceptibility to different antibiotics by Broth microdilution test. Interpretation of susceptibility was done according to the Clinical and Laboratory Standards Institute (CLSI) 2017 guidelines.
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