Conclusions
uropathogens
EMERGENCY
In this paper we evaluated the performance of a new Point Of Care Test (POCT) for the rapid prediction of antimicrobial susceptibility of uropathogens. 349 patients were enrolled in two open-label, monocentric, non-interventional clinical trials in partnership with an Emergency Medicine ward and the Day Hospital of two large healthcare facilities in Rome, Italy. The pool of patients and antibiotic tested was contained, therefore the study can be considered as a preliminary investigation that has, however, provided promising results.Overall, the MBS AST POCT displayed high accuracy (greater than 90%), and PPV (greater than 95%) with all the tested antibiotics, and provided results in less time compared to traditional methods, especially for resistant bacteria, that were detected within 12 hours from urine collection.Based on these evidences, the use of such a POCT in routine clinical practice could have an important impact, allowing an accurate evaluation of susceptibility/resistance of the infecting bacteria to selected antibiotics, though reducing analytical time and labor and diminishing analytical and management costs. Yielding results within a working day would indeed allow clinicians to promptly treat patients without the need of empiric antibiotic therapy, thus ultimately, helping to counteract the rise of antibiotic resistance.The device provides important information about the efficacy of antibiotics of interest directly testing urine samples and thus taking into account the overall urinary bacterial population, therefore preventing important data loss. The method itself does not provide the identification of pathogenic agents, however this can be easily achieved immediately after the analysis, using positive vials as bacterial cultures, ready to be further analyzed with standard techniques.Moreover, the MBS AST POCT could prove useful in the assessment of local antimicrobial susceptibility patterns providing a tool for the rapid screening of urine samples and allowing to build an antibiotic susceptibility database within the hospital even in low-resource settings.The authors gratefully acknowledge Dr. Andreas Bergmann (Sphingotec GmbH, 16761 Hennigsdorf, Germany), Dr. Metod Miklus, Dr. Robert Hellmich and Dr. Paul Scigalla (Oncoprevent GmbH, 16761 Hennigsdorf, Germany), for helpful discussions.Dr. Vincenzo Ziparo passed away before the submission of the final version of this manuscript. Dr. Giovanni Antonini accepts responsibility for the integrity and validity of the data collected and analyzed.