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The aim of the study was to evaluate the concordance of the rapid antimicrobial susceptibility testing (AST) results obtained by the HB&L Uroquattro instrument performed directly from positive urine sam¬ples in comparison with the standard Kirby-Bauer disk-diffusion method performed with isolated colonies. We included 122 urine samples defined as positive by the HB&L system screening method. The AST was performed directly from them by the HB&L instrument. Simultaneously, all positive urine samples were cultured on CLED, MacConkey and Blood agar and incubated for 24h at 37°C. Species identification and AST of the pathogens isolated on solid media were done by the VITEK 2 automated system (bioMerieux) and respectively by the Kirby-Bauer disk-diffusion method. We defined one hundred and twenty-two pos¬itive urine samples:60 Enterobacterales, 42 Enterococcus faecalis, and 20 Staphylococcus saprophyticus isolates. A total of 690 susceptibility determinations were performed with a categorical agreement with the standard method of 94.8%. Thirty-six errors (5.2%) were found. Of these, only 5 very major errors were detected, associated with trimethoprime/sulfamethoxazole susceptibility testing among Enterobacterales, glycopeptides, and HLAR among enterococci and cefoxitin susceptibility among staphylococci. The turn¬around time for AST directly from positive urine samples was between 3 and 5 hours versus 48 hours for the standard disk-diffusion method from isolated colonies. The rapidity of the HB&L AST method and its very good categorical correlation with the standard disk-diffusion method determine the potential of the system for wide application in routine laboratory practice.
Snegarova et al. (Sun,) studied this question.