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September 2, 2026Journal of Clinical Microbiology0 citationsOpen Access

Evaluation of Rapid Antimicrobial Susceptibility Testing for Gram-Negative Blood Cultures

Multisite clinical evaluation of the iFAST rapid antimicrobial susceptibility test direct from positive blood cultures containing gram-negative organisms

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Authors

MHMichael HornseyITIsobel TaylorTKToby King

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Overview

Multisite diagnostic study demonstrates high accuracy of rapid susceptibility testing in gram-negative blood cultures within four hours, highlighting its utility for same-shift targeted therapy.

Key Points

  • To assess the diagnostic accuracy and reproducibility of the rapid iFAST antimicrobial susceptibility test directly from positive blood culture bottles containing gram-negative bacteria.
  • Evaluated 375 Enterobacterales and non-fermenting gram-negative isolates directly from positive blood culture bottles across three centers following ISO 20776-2:2021 guidelines.
  • Compared iFAST performance (<4-hour turnaround measuring single-cell electrical properties) against reference broth microdilution methods.
  • Tested reproducibility across three sites using 12 isolates in triplicate on three separate days with different operators.
  • Categorical agreement with broth microdilution was 97.8% for Enterobacterales and 97.2% for non-fermenting gram-negative species.
  • Enterobacterales testing showed 98.2% specificity and 96.8% sensitivity, while non-fermenting species showed 96.9% specificity and 98.4% sensitivity, exceeding the ≥95% threshold.
  • Inter-site and operator reproducibility reached an overall agreement of 95.7% across replicates.

Cite This Study

Hornsey et al. (2026) studied this question.

synapsesocial.com/papers/6a97e29ec562ede874ec6dc4https://doi.org/10.1128/jcm.00558-26
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