Ann Clin Microbiol 2025;28(2):9. Diagnostic stewardship in clinical microbiology: current status and perspectives in Korea
| Platform/kit (manufacturer) | Species-identification range | Antimicrobial-resistance determination |
|---|---|---|
| Molecular diagnostics | ||
| cobas® ePlex BCID Panels (Roche Diagnostics) | BCID-GP: 20 GP with Pan-GN, Pan-Candida BCID-GN: 21 GN with Pan-GP, Pan-Candida BCID-FP: 15 fungal organisms | mecA, mecC, vanA, vanB, CTX‑M, IMP, KPC, NDM, OXA‑23/48, VIM |
| BioFire® FilmArray BCID2 (bioMérieux) | 33 organism targets: 11 GP, 15 GN, 7 yeasts | mecA/C, MREJ, vanA/B, KPC, NDM, VIM, IMP, OXA‑48‑like, CTX‑M, mcr-1 |
| VERIGENE® BCID Panels (DiaSorin) | BC‑GP: 13 GP genus/species BC‑GN: 9 GN genus/species | BC‑GP: mecA, vanA, vanB BC‑GN: CTX‑M, IMP, KPC, NDM, OXA, VIM |
| T2Candida® Panel (T2 Biosystems)a) | 5 Candida species directly from whole blood | None |
| MALDI Biotyper (Bruker) | Full range cover, ≥ 4,000 bacterial and fungal species – MBT Sepsityper (IVD), ≥425 microorganisms from positive blood cultures | Carbapenemase and cephalosporinase using MBT-STAR (IVD) Colistin resistance using MBT Lipid Xtract (RUO) Detection of blaKPC and cfiA using MBT HT Subtyping (IVD) |
| Vitek MS (bioMérieux) | Full range cover, ≥ 1,000 bacterial and fungal species | None |
| Rapid phenotypic AST | Usually combined with direct species identification from positive blood cultures by MALDI-TOF | |
| dRAST (Quantamatrix Inc.) | GN and GP panel based on gram-stained microscopy of positive blood culture bottles | Phenotypic MICs based on microscopic imaging for 17–19 antimicrobials in 5–7 h |
| Accelerate PhenoTest BC kit (Accelerate Diagnostics, Inc.) | 14 common bloodstream pathogens identified in 2 h | Phenotypic MICs based on microscopic imaging for 12–16 antimicrobials in 7 h |
| Blood culture-GN (PhAST)b) | GN panel based on gram-stained microscopy of positive blood culture bottles | Phenotypic MICs based on microscopic imaging for 10 antimicrobials in 1 h |
| VITEK REVEAL (bioMérieux) | GN panel based on gram-stained microscopy of positive blood culture bottles | Phenotypic MICs based on sensing volatile organic metabolite produced by bacterial growth for 17–19 antimicrobials in 5 h |
| EUCAST RAST | 8 common bloodstream pathogens | Disk diffusion in 4–8 h or 16–20 h |
| CLSI RAST | Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter species | Disk diffusion in 8–10 h or 16–18 h |
a) Under process for IVD approval of Korea Ministry of Food and Drug Safety; b) Under process for IVD approval of US Food and Drug Administration. Abbreviations: MALDI, matrix-assisted laser desorption ionization; GP, gram-positive; GN, gram-negative; IVD, in vitro diagnostics; RUO, research use only; MS, mass spectrometry; AST, antimicrobial susceptibility testing; RAST, rapid antimicrobial susceptibility testing; MALDI-TOF, MALDI time-of-flight; MIC, minimum inhibitory concentration; EUCAST, European Committee in Antimicrobial Susceptibility Testing; CLSI, Clinical and Laboratory Standards Institute.