REPORTing of Antimicrobial Resistance from Blood Cultures (REPORT-ABC), an ARLG Survey Summary: Resistance Marker Reporting Practices from Positive Blood Cultures.

Overview

abstract

BACKGROUND: The purpose of this study was to assess how laboratories are using and handling reporting of rapid diagnostics, with a focus on antimicrobial resistance (AMR) markers from multiplex molecular panels, performed on positive blood culture broths. METHODS: A survey assembled by the Antibacterial Resistance Leadership Group (ARLG) Diagnostics Committee (DC) was circulated from December 2020 to May 2021. The survey was sent to local hospitals, shared on the ClinMicroNet and Division C listservs, and included in a College of American Pathologists (CAP) proficiency testing survey. RESULTS: Ninety-six laboratories of various sizes across the United States (US; 95%) and outside of the US (5%) participated. Of the laboratories that had at least one rapid diagnostic in place (94%), significant heterogeneity in methods used and reporting practices was found across community (52%) and academic (40%) laboratories serving hospitals of various sizes. Respondents had implemented 1 to 6 different panels/platforms for a total of 31 different permutations. Methods of reporting rapid organism identification and AMR results varied from listing all targets as "Detected"/"Not detected" (16-22%) without interpretive guidance, to interpreting results (23-42%), or providing therapeutic guidance comments to patient-facing healthcare teams (3-17%). CONCLUSIONS: Current approaches to reporting molecular AMR test results from positive blood culture varies significantly across clinical laboratories. Providing interpretative comments with therapeutic guidance within the result report may assist clinicians less familiar with the genetic mechanisms of AMR, but this is not currently being done in all clinical laboratories. Standardized strategies for AMR gene result reporting are needed.