Advancing antimicrobial susceptibility testing in body fluid-associated infections: a focus on direct testing for timely and targeted therapeutic interventions

Background: timely Antimicrobial Susceptibility Testing (AST) is critical in managing infections, particularly with the rise of multidrug-resistant organisms. This study evaluates the efficacy of Direct AST (D-AST) on body fluids in reducing turnaround time compared to Routine AST (R-AST). Materi...

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Main Authors: Nisha Goyal, Vikas Saini, Nimisha Jain, Bandi Shravana, Shukla Das, Narendra Pal Singh, Meenakshi Goswami
Format: Article
Language:English
Published: PAGEPress Publications 2025-08-01
Series:Microbiologia Medica
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Online Access:https://www.pagepressjournals.org/mm/article/view/13602
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author Nisha Goyal
Vikas Saini
Nimisha Jain
Bandi Shravana
Shukla Das
Narendra Pal Singh
Meenakshi Goswami
author_facet Nisha Goyal
Vikas Saini
Nimisha Jain
Bandi Shravana
Shukla Das
Narendra Pal Singh
Meenakshi Goswami
author_sort Nisha Goyal
collection DOAJ
description Background: timely Antimicrobial Susceptibility Testing (AST) is critical in managing infections, particularly with the rise of multidrug-resistant organisms. This study evaluates the efficacy of Direct AST (D-AST) on body fluids in reducing turnaround time compared to Routine AST (R-AST). Materials and Methods: over six months, 43 monobacterial body fluid samples were analyzed using both D-AST and R-AST at a tertiary care hospital. D-AST was performed on the same day of sample receipt, while R-AST followed Clinical and Laboratory Standards Institute (CLSI) guidelines. Concordance between the methods was statistically assessed. Results: D-AST showed high concordance with R-AST for most antibiotics (p>0.05), with a significant reduction in turnaround time (D-AST: 24-36 hours; R-AST: 48-72 hours). For Gram-negative organisms, discrepancies were noted for amikacin sensitivity in Escherichia coli (D-AST: 76.19%; R-AST: 90.4%) and ciprofloxacin in Klebsiella pneumoniae (D-AST: 80%; R-AST: 100%). Gram-positive organisms showed 100% concordance for key antibiotics like linezolid and teicoplanin. Conclusions: D-AST is a reliable, rapid alternative to R-AST, enabling earlier therapeutic decisions and reducing empirical antibiotic use. It shows promise in improving outcomes and combating antimicrobial resistance, particularly in resource-limited settings. Further standardization is needed for broader application.
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spelling doaj-art-12a227fb414c47caafe32269a150a1f72025-08-20T03:35:32ZengPAGEPress PublicationsMicrobiologia Medica2280-64232025-08-0140110.4081/mm.2025.13602Advancing antimicrobial susceptibility testing in body fluid-associated infections: a focus on direct testing for timely and targeted therapeutic interventionsNisha Goyal0Vikas Saini1Nimisha Jain2Bandi Shravana3Shukla Das4Narendra Pal Singh5Meenakshi Goswami6Department of Microbiology, University College of Medical Sciences and Guru Tag Bahadur Hospital, DelhiDepartment of Microbiology, Satyawadi Raja Harish Chand Hospital, DelhiUniversity College of Medical Sciences and Guru Tag Bahadur Hospital, DelhiDepartment of Microbiology, University College of Medical Sciences and Guru Tag Bahadur Hospital, DelhiDepartment of Microbiology, University College of Medical Sciences and Guru Tag Bahadur Hospital, DelhiDepartment of Microbiology, Super Speciality Paediatric Hospital & Post Graduate Teaching Institute, NoidaDepartment of Microbiology, University College of Medical Sciences and Guru Tag Bahadur Hospital, Delhi Background: timely Antimicrobial Susceptibility Testing (AST) is critical in managing infections, particularly with the rise of multidrug-resistant organisms. This study evaluates the efficacy of Direct AST (D-AST) on body fluids in reducing turnaround time compared to Routine AST (R-AST). Materials and Methods: over six months, 43 monobacterial body fluid samples were analyzed using both D-AST and R-AST at a tertiary care hospital. D-AST was performed on the same day of sample receipt, while R-AST followed Clinical and Laboratory Standards Institute (CLSI) guidelines. Concordance between the methods was statistically assessed. Results: D-AST showed high concordance with R-AST for most antibiotics (p>0.05), with a significant reduction in turnaround time (D-AST: 24-36 hours; R-AST: 48-72 hours). For Gram-negative organisms, discrepancies were noted for amikacin sensitivity in Escherichia coli (D-AST: 76.19%; R-AST: 90.4%) and ciprofloxacin in Klebsiella pneumoniae (D-AST: 80%; R-AST: 100%). Gram-positive organisms showed 100% concordance for key antibiotics like linezolid and teicoplanin. Conclusions: D-AST is a reliable, rapid alternative to R-AST, enabling earlier therapeutic decisions and reducing empirical antibiotic use. It shows promise in improving outcomes and combating antimicrobial resistance, particularly in resource-limited settings. Further standardization is needed for broader application. https://www.pagepressjournals.org/mm/article/view/13602Direct Antimicrobial Susceptibility Testing (D-AST)body fluid infectionsAntimicrobial Resistance (AMR)rapid diagnostic methodsempirical therapy reduction
spellingShingle Nisha Goyal
Vikas Saini
Nimisha Jain
Bandi Shravana
Shukla Das
Narendra Pal Singh
Meenakshi Goswami
Advancing antimicrobial susceptibility testing in body fluid-associated infections: a focus on direct testing for timely and targeted therapeutic interventions
Microbiologia Medica
Direct Antimicrobial Susceptibility Testing (D-AST)
body fluid infections
Antimicrobial Resistance (AMR)
rapid diagnostic methods
empirical therapy reduction
title Advancing antimicrobial susceptibility testing in body fluid-associated infections: a focus on direct testing for timely and targeted therapeutic interventions
title_full Advancing antimicrobial susceptibility testing in body fluid-associated infections: a focus on direct testing for timely and targeted therapeutic interventions
title_fullStr Advancing antimicrobial susceptibility testing in body fluid-associated infections: a focus on direct testing for timely and targeted therapeutic interventions
title_full_unstemmed Advancing antimicrobial susceptibility testing in body fluid-associated infections: a focus on direct testing for timely and targeted therapeutic interventions
title_short Advancing antimicrobial susceptibility testing in body fluid-associated infections: a focus on direct testing for timely and targeted therapeutic interventions
title_sort advancing antimicrobial susceptibility testing in body fluid associated infections a focus on direct testing for timely and targeted therapeutic interventions
topic Direct Antimicrobial Susceptibility Testing (D-AST)
body fluid infections
Antimicrobial Resistance (AMR)
rapid diagnostic methods
empirical therapy reduction
url https://www.pagepressjournals.org/mm/article/view/13602
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