(P) Versatrek Training Flashcards
video lecture-based
TOF. VERSATREK is an automated blood culture system.
T
versaTREK is manufactured by?
ThermoFischer Scientific
PRINCIPLES OF AUTOMATED BLOOD CULTURE MACHINE (3)
● Colorimetric Technology
● Fluoreescent Technology
● Pressure Change Detection
- organisms grow in media and produce carbon dioxide (CO2)
- CO2 passes through semi-permeable membrane located at the bottom of the blood culture bottle
- sensor changes from green to yellow
- Positive butt of culture bottle will be detected by the blood culture analyzer
COLORIMETRIC TECHNOLOGY
COLORIMETRIC TECHNOLOGY
It is based on what chemistry?
Growth chemistry
COLORIMETRIC TECHNOLOGY
Indicators:
- Green
- Yellow
- Negative
- Positive
- Organism metabolic activity releases CO2
- Carbon dioxide reacts with dye in vial sensor located at the bottom of the blood culture bottle
- LED-activated fluorescent material in sensor.
- Photodetector reads fluorescence
- Raw data from detector is analyzed by row board
- And positivity analysis is performed
- Positive vial is announced by audible alert, on screen indications, and the Positive Vial system indicator.
FLUORESCENT TECHNOLOGY
FLUORESCENT TECHNOLOGY
This reacts with dye in vial sensor located at the
bottom of the blood culture bottle?
CO2
FLUORESCENT TECHNOLOGY
modulated by dye in the sensor
Fluorescence
FLUORESCENT TECHNOLOGY
This reads the fluorescence
Photodetector
FLUORESCENT TECHNOLOGY
Positive vial is announced by audible alert, on screen
indications, and the?
Positive Vial system indicator
- This principle is utilized by VersaTREK Technology
- During metabolism, microorganisms produce and/or consume gases (CO2, H2, O2, N2, etc.)
PRESSURE CHANGE DETECTION
PRESSURE CHANGE DETECTION
They measure these changes in pressure in the
headspace of inoculated bottles over time to determine positivity
VersaTREK
TOF. Production decreases pressure while consumption increases.
F (reverse)
PRESSURE CHANGE DETECTION
No CO2 limitations in VersaTREK’s TI
itz a technology
Comprehensive Detection Technology (CDT)
Consumption of oxygen is decreased in pressure followed by constant pressure which gradually decreases, then the rapid or sharp increase of pressure that is now called
carbon dioxide production
TOF. When microbes may not produce a sufficient amount of CO2, this can become a problem for colorimetric or fluorescence technology.
T
- Connector provides the link (via a recessed probe) for headspace pressure measurement
- Allows dissipation of gases produced during metabolism
VERSATREK SAFETY - CONNECTOR
VERSATREK SAFETY - CONNECTOR
a component in the connector prevents
aerosol escape
Hydrophobic membrane
- A major advantage of VersaTREK Technology by continuously stirring the culture media in the bottle
- Proven to be 2 hours faster than the stir bar
VORTEXING
Author of Preliminary Development and Verification of a New Agitation Method for the ESP Culture Technology
N.M Sullican and D. Fett
ESP Culture Technology
TOF. These data show that the stir bar agitation method is a very effective method when used with the ESP technology
T
ORGANISMS THAT SIGNAL ON GAS PRODUCTION
● Staphylococcus aureus
● Staphylococcus epidermidis
● Staphylococcus pneumoniae
● Enterococcus faecalis
● Escherichia coli
● Candida albicans
● Klebsiella pneumoniae
SSSEECK
ORGANISMS THAT SIGNAL ON GAS CONSUMPTION
● Brucella suis
● Helicobacter spp.
● Nocardia spp.
● Campylobacter spp.
● Brevundimonas vesicularis
● Rhodococcus equi
● Trichoporum beigelli
Advantages of VERSATREK TECHNOLOGY
4
- CDT
- NO LOW-CO2 LIMITATIONS
- NO HIGH WBC LIMITATIONS
- FOUR-IN-ONE SYSTEM
- Competitive systems rely on CO2 production
- Many fastidious organisms do not produce CO2
- Maximum Recovery and Minimum TTD for Campylobacter spp., Neisseria spp., Brucella spp., etc.
NO LOW-CO2 LIMITATIONS
● Pressure-based system
● Extensive algorithms distinguish bacterial growth from WBC metabolism up to 100,000
● Reduction of false positives and workflow disruptions
NO HIGH WBC LIMITATIONS
VersaTREK is the only one system with 4 US FDA-cleared applications on 1 platform:
○ Blood Culture (0.1-10 mL)
○ Sterile body fluids
○ Mycobacteria detection
○ Mycobacterium TB susceptibility testing
FOUR-IN-ONE SYSTEM
blood-to-broth dilution ratio of most blood culture bottles in the market
1:4
blood-to-broth dilution ratio for Thermo Fisher Scientific
1:8
VERSATREK BOTTLES
What is diluted to neutralize and increase the sensitivity of detection for the cause of infection
VERSATREK BOTTLES
BENEFITS OF VERSATREK
➢ Enhance fastidious detection
A. Vortexing
B. Gas consumer/producer
C. Lower SPS
D. Blood-to-broth ratio (1:8) Dilution
B
BENEFITS OF VERSATREK
➢ Faster time to detection
A. Vortexing
B. Gas consumer/producer
C. Lower SPS
D. Blood-to-broth ratio (1:8) Dilution
2 answers
A and B
BENEFITS OF VERSATREK
➢ Less inhibitor, superior to recover
fastidious organisms
A. Vortexing
B. Gas consumer/producer
C. Lower SPS
D. Blood-to-broth ratio (1:8) Dilution
C
BENEFITS OF VERSATREK
➢ Easier stock management
A. ONE bottle for all-purpose
B. Gas consumer/producer
C. Lower SPS
D. Blood-to-broth ratio (1:8) Dilution
A
BENEFITS OF VERSATREK
➢ Dilutes antibiotics and serum
cofactors
A. ONE bottle for all-purpose
B. Gas consumer/producer
C. Lower SPS
D. Blood-to-broth ratio (1:8) Dilution
D
BENEFITS OF VERSATREK
➢ Detection even for low blood
volume collection
A. ONE bottle for all-purpose
B. FDA-cleared blood volume
C. FDA cleared for 4 platforms
D. Blood-to-broth ratio (1:8) Dilution
B
BENEFITS OF VERSATREK
➢ Comprehensive organisms detect
from blood, sterile body, Mycobacteria ID, Mycobacteria AST
A. ONE bottle for all-purpose
B. FDA-cleared blood volume
C. FDA cleared for 4 platforms
D. Blood-to-broth ratio (1:8) Dilution
C
GUIDELINES FOR BLOOD CULTURE COLLECTION
No Blood sets/episode
* USA CLSI
* USA ASM
* Europe ESCMID
* Australia
- USE CLSI, USA ASM, Europe ESCMID - 2-3
- Autralia - 2
GUIDELINES FOR BLOOD CULTURE COLLECTION
paaral nalang iba sori dcrammer
thx
Number of Blood Culture Set and state their % Detection
* 1 set (20 mL)
* 2 sets (40 mL)
* 3 sets (60 mL)
* 4 sets (80 mL)
- 65%
- 80%
- 96%
- Nearly 100%
BLOOD CULTURE COLLECTION PROCEDURE
paaral nalang po thx
mwah mwah
- skin prep
- bottle prep
- VENIPUNCTURE AND BOTTLE INOCULATION
VENIPUNCTURE AND BOTTLE INOCULATION
3 options
- NEEDLE AND SYRINGE
- BLOOD COLLECTION DEVICE
When your blood culture analyzer signals positive, you unload the positive culture bottle and perform the following:
4
- gram stain
- isolation
- ID/AST
- Reporting
POSITIVE BLOOD CULTURE WORKUP
■ Subculture to media
■ Isolation of causative pathogen
■ Blood Agar
■ Additional Media: (MacConkey Agar, Chocolate
Agar, Anaerobic Blood Agar)
ISOLATION
POSITIVE BLOOD CULTURE WORKUP
■ Work-up of culture
■ Biochemical ID kit
■ Mueller Hinton Agar/Kirby Bauer
■ MICE
■ Sensititre System (ThermoFisher Scientific)
ID/AST
REPORTING
No growth
● No growth at 24 hours
● No growth at 48 hours
PRELIMINARY RESULT
● Positive Blood Culture
perform what
○ Gram stain result
○ Preliminary ID
■ Gram-positive cocci
■ Gram-positive bacilli
■ Gram-negative bacilli
FINAL RESULT
No growth after the length of incubation
○ After 5 days (according to CLSI)
○ After 7 days (according to ASM)
FINAL RESULT
Positive Blood Culture
○ Final Gram Stain Result
○ Final ID
○ Final AST
● Alternative to automated blood culture system
● Also based on pressure change
MANUAL BLOOD CULTURE
MANUAL BLOOD CULTURE
1
SIGNAL BLOOD CULTURE SYSTEM
Four tests in one platform
○ Blood (Culture)
○ Sterile (Body Fluids)
○ Mycobacteria (Detection)
○ MTB Susceptibility