{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:13:38Z","timestamp":1793661218690,"version":"4.5.1"},"reference-count":36,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Gradientech"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Rapid availability of phenotypic susceptibility results is crucial for the timely detection of multidrug-resistant Gram-negative organisms. Several novel methods have been introduced that enable direct antimicrobial susceptibility testing (AST) from positive blood cultures. This study aimed to assess the analytical performance of the agar diffusion-based EUCAST rapid AST (RAST) method and the automated QuickMIC system using a challenging collection of highly resistant Gram-negative organisms. One hundred one Gram-negative bacteria (\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 24;\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 22;\n                      <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 30; and\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 25) were spiked into blood cultures and processed according to the respective AST protocols. Broth microdilution (BMD) was performed as the reference method. Time to result (TTR), categorical agreement (CA), and essential agreement (EA) with BMD were evaluated. Boruta analysis was applied to identify genetic determinants associated with AST errors. Overall TTR for QuickMIC was 3 h 44 min with a CA of 86.2% and an EA of 92.3% for\n                      <jats:italic toggle=\"yes\">Enterobacteriaceae<\/jats:italic>\n                      and 97.0% for non-fermenters. Overall CA of RAST ranged from 90.7% to 93.7% across reading time points. Overall, very major discrepancy rates were low (QuickMIC,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 0.7%, and RAST,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 0.1%). Presence of NDM-5 and KPC was most frequently associated with errors for QuickMIC and EUCAST RAST, respectively. Both rapid AST approaches yielded rapid and robust results in this diverse and highly resistant bacterial study population. These findings underscore the potential of rapid AST methods to facilitate timely optimization of antimicrobial therapy in bloodstream infections, even in the context of extensively drug-resistant pathogens.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        Accurate antimicrobial susceptibility testing (AST) is essential for stewardship and effective therapy, especially as rising antimicrobial resistance increases the risk of empiric treatment failure. Traditional AST methods are limited by slow turnaround times, creating a need for rapid alternatives. This study evaluated the diagnostic accuracy of two rapid AST (RAST) methods\u2014EUCAST RAST and QuickMIC\u2014using 101 genetically characterized, carbapenem-resistant Enterobacterales,\n                        <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                        , and\n                        <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                        tested directly from positive blood cultures. Broth microdilution served as the reference. Both rapid assays provided results within 3.5\u20136 h and demonstrated high categorical and essential agreement with few very major discrepancies. Incorrect results were more common in isolates harboring NDM-5 and KPC carbapenemases. Overall, the findings support EUCAST RAST and QuickMIC as reliable tools for challenging resistant pathogens and highlight their potential to enable earlier detection of carbapenem-resistant phenotypes and more timely initiation of appropriate, last-resort antimicrobial therapy.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.03956-25","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T01:19:26Z","timestamp":1782868766000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Comparative evaluation of EUCAST RAST and QuickMIC for rapid antimicrobial susceptibility testing of carbapenem-resistant organisms directly from positive blood cultures"],"prefix":"10.1128","volume":"14","author":[{"given":"Nicole","family":"Degel-Brossmann","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01zgy1s35","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf","place":["Hamburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Kimkes","sequence":"additional","affiliation":[{"name":"Gradientech AB","place":["Uppsala, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Reibenspies","sequence":"additional","affiliation":[{"name":"Gradientech AB","place":["Uppsala, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiabin","family":"Huang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01zgy1s35","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute for Medical Microbiology, Virology and 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