{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:54:51Z","timestamp":1777420491444,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2018,3,20]],"date-time":"2018-03-20T00:00:00Z","timestamp":1521504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Accelerate Diagnostics, Inc."}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:p>\n                    Background: The Accelerate PhenoTest\n                    <jats:sup>TM<\/jats:sup>\n                    BC kit (AXDX) provides rapid organism identification (ID) and antimicrobial susceptibility testing (AST) results. Its potential role for antimicrobial stewardship is unknown. Objective: To compare the diagnostic accuracy of AXDX with conventional methods (CMs) and assess AXDX\u2019s potential role for antimicrobial stewardship in patients with Gram-positive bloodstream infections (BSIs). Methods: This retrospective cohort study included adults with Staphylococcus aureus or Enterococcus spp BSIs from July 2014 to January 2016 at a tertiary care medical center. Available isolates were tested on AXDX, and ID and AST results from AXDX were compared with those from CMs (VITEK 2 or ETEST). The following antibiotics were assessed for categorical agreement (CA) and essential agreement (EA) between the methods: ampicillin and daptomycin ( Enterococcus spp only), erythromycin and cefoxitin ( S aureus only), linezolid, and vancomycin. Potential role of AXDX for stewardship was assessed via a retrospective audit by infectious diseases clinicians. Results: We included 231 patients with S aureus (n = 112) or Enterococcus spp (n = 119) BSIs, and 106 unique isolates were available for ID and AST performance analyses. Sensitivity and specificity of AXDX for ID were 98.0% and 99.5%, respectively. CA and EA for the tested antibiotics were &gt;97%. In Monte Carlo simulations, AXDX coupled with stewardship personnel (either 24\/7 or Monday to Friday) would have allowed unnecessary therapy to be stopped and active\/targeted therapy to be started \u226524 hours sooner in &gt;50% of patients. Conclusions: Compared with CMs, AXDX had similar diagnostic accuracy and can potentially optimize therapy sooner in patients with Gram-positive BSIs.\n                  <\/jats:p>","DOI":"10.1177\/1060028018765486","type":"journal-article","created":{"date-parts":[[2018,3,20]],"date-time":"2018-03-20T07:26:17Z","timestamp":1521530777000},"page":"754-762","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Accelerate PhenoTest\n                    <sup>TM<\/sup>\n                    BC Kit Versus Conventional Methods for Identification and Antimicrobial Susceptibility Testing of Gram-Positive Bloodstream Isolates: Potential Implications for Antimicrobial Stewardship"],"prefix":"10.1177","volume":"52","author":[{"given":"Amelia K.","family":"Sofjan","sequence":"first","affiliation":[{"name":"University of Houston College of Pharmacy, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin O.","family":"Casey","sequence":"additional","affiliation":[{"name":"University of Houston College of Pharmacy, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boxin A.","family":"Xu","sequence":"additional","affiliation":[{"name":"University of Houston College of Pharmacy, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Amadio","sequence":"additional","affiliation":[{"name":"University of Houston College of Pharmacy, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Restrepo","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Jahangir","family":"Alam","sequence":"additional","affiliation":[{"name":"University of Houston College of Pharmacy, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2063-7503","authenticated-orcid":false,"given":"Kevin W.","family":"Garey","sequence":"additional","affiliation":[{"name":"University of Houston College of Pharmacy, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,3,20]]},"reference":[{"key":"bibr1-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306801"},{"key":"bibr2-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2014.02.012"},{"key":"bibr3-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ308"},{"key":"bibr4-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1086\/510386"},{"key":"bibr5-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw110"},{"key":"bibr6-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.36.7.1923-1926.1998"},{"key":"bibr7-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2014.09.025"},{"key":"bibr8-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ447"},{"key":"bibr9-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit498"},{"key":"bibr10-1060028018765486","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2012-0651-OA"},{"key":"bibr11-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2013.07.007"},{"key":"bibr12-1060028018765486","volume-title":"Accelerate PhenoTestTM BC Kit: Instructions for Use","author":"Accelerate Diagnostics, Inc","year":"2017"},{"key":"bibr13-1060028018765486","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp100635"},{"key":"bibr14-1060028018765486","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw217"},{"key":"bibr15-1060028018765486","unstructured":"Food and Drug Administration. 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