Lab Medicine Significance 7/10

eQUANT System Enables Same-Day Disk Diffusion AST Directly from Positive Blood Cultures

A multicenter study evaluated the Avails eQUANT system, which generates a standardized 0.5 McFarland suspension directly from positive blood culture bottles, eliminating the subculture step for disk diffusion AST. Testing 2,679 result pairs across 13 Gram-negative species and 12 antibiotics yielded 95.0% categorical agreement with standard next-day methods, with very major and major error rates of just 0.15% and 0.60%. The system can save up to 24 hours in the AST reporting workflow for bloodstream infections.

The original study

Multicenter evaluation of the eQUANT system for use with disk diffusion AST of gram-negative bacteria directly from positive blood cultures.

Authors
Dutta S, Jacobs MR, Good CE, Abdelhamed AM, Ying YC, Hoyos-Urias A, et al.
Journal
Journal of clinical microbiology
Type
Journal Article, Multicenter Study, Evaluation Study
PMID
40340515
Read the original study →

Original abstract

Bloodstream infections frequently cause sepsis, a condition that can lead to organ dysfunction and death. Rapid antimicrobial susceptibility testing (AST) results are critical for appropriate medical intervention and to either de-escalate or escalate antibiotics to appropriate therapy. We describe the results from a multicenter clinical study evaluating the performance of the eQUANT system (Avails Medical, Inc., Menlo Park, CA). The eQUANT system generates a 0.5 McFarland equivalent suspension, the eMcFarland, directly from a positive blood culture bottle for use with downstream disk diffusion AST, thereby saving up to 24 hours compared to traditional AST workflow. A combination of fresh, prospectively collected clinical (42) and contrived (525) blood cultures were tested, and results for disk diffusion using the Avails eQUANT eMcFarland suspension as the inoculum were compared to disk diffusion results the next day using the standard 0.5 McFarland suspension prepared from plate subculture. Thirteen species of gram-negative rods were evaluated against 12 antibiotics. From the 2,679 pairs of AST results, overall categorical agreement was 95.0%. Overall very major errors, major errors, and minor errors were 0.15%, 0.60%, and 4.48%, respectively. The Avails eQUANT system has the potential to significantly accelerate the standard of care by eliminating the need for subculture.IMPORTANCERapid reporting of antimicrobial susceptibility test results for bacterial isolates from blood cultures is critical for timely implementation of optimal antimicrobial therapy and improves outcomes of sepsis patients. In this study, we demonstrate the accuracy and performance characteristics of the eQUANT system, which generates a 0.5 McFarland equivalent suspension, the eMcFarland, directly from a positive blood culture bottle for use with downstream disk diffusion antimicrobial susceptibility testing (AST). Using the eMcFarland suspension allows for accurate and standardized reporting of disk diffusion AST results from positive blood cultures.