Mass Spectrometry Pg 2VITEK® 2 PC5.01 Pg 3

Henry Ford Hospital Pg 5ProLab Pg 6

New VITEK® 2 Cards Pg 8Total AST Pg 11

Events Calendar Pg 12

July 2011

IN THIS ISSUE:

2

Mass Spectrometry: Cutting Edge Microbial IdentificationNedal Safwat, Ph.D.Senior US Clinical Marketing ManagerbioMérieux, Inc.Durham, NC

The rapid identification of microorganisms has been a major obstacle to clinicians as they struggle to provide appropriate antimicrobial treatment while waiting sometimes days for adefinitive identification of the pathogen. Now, a new method has emerged that can reduce identification to a few minutes. Mass Spectrometry (MS) is a technique used to screen simultaneously a multitude of molecules and determine their identity by analyzing their individual mass-to-charge ratio. These molecular “signatures” can be used for rapid bacterial and fungal identification (ID) from isolated colonies. The use of mass spectrometry for bacterial ID promises to be particularly suitable and cost-efficient for laboratories with high volumes of samples. But the big payoff for clinicians is the huge reduction in the time it takes to identify organisms. Specifically, mass spectrometry enables laboratories to rapidly identify organisms from colonies grown overnight.

This technology may also assist clinical microbiologists in facing the ever-increasing number of potentially pathogenic species of bacteria and fungi. A modern identification system such as MS, coupled with a flexible database that can be easily updated and expanded, can meet this growing challenge.

What does MALDI-TOF stand for?MALDI-TOF stands for Matrix Assisted Laser Desorption/Ionization – Time Of Flight. It describes the way a sample isconverted into charged particles, or ionized, and what method has been used to separate the different mass particles after charging. A spectrum is produced by measuring and plotting the different mass particles.

Lab of the Future bioMérieux is moving quickly to provide an integrated solution to this emerging technology through a partnership agreement with Shimadzu, a pioneer in the development of MALDI-TOF MS technology, and by acquiring a comprehensive microbial mass spectra database from AnagnosTec, a primary innovator in MALDI-TOF MS microbial identification. For microbiologists who choose

mass spectrometry for microbial ID, bioMérieux is developing integrated workflow solutions with its VITEK® 2range to ensure optimal user convenience, full sample traceability and quality of results. All of bioMérieux’s systems will be managed with the new MYLA™ Web-based middleware solution, commercialized in early 2011. The fully integrated system will provide rich connectivity, enhanced information and workflow management.

* Research Use Only - Not for use in diagnostic procedures.

bioMérieux Connection July 2011 3

Microbiology laboratories are struggling with challenges that impede their ability to complete their work in a timely manner. Loss of skilled labor, increasing pressure to deliver more rapid results and coping with increasing workloads create issues that take time to resolve. This highlights the need for increased productivity by eliminating inefficient steps in our day-to-day activities.

bioMérieux’s new software release for the VITEK® 2 PC has features designed to help you become more efficient by saving you steps and saving you time.

New VITEK® 2 PC5.01 Software Release: A Major Leap ForwardNedal Safwat, Ph.D.Senior U.S. Clinical Marketing ManagerbioMérieux, Inc.Durham, NC

This new software release has an optional feature which allows users to access the VITEK 2 PC remotely to view and validate results.

Avoid walking from one location to AnotherThese wasted steps can be taken back through remote access to the VITEK 2 PC computer.

Fast reportingImpaired workflow process allows users to recapture timepreviously spent walking results from one location to another and to verify results on their own time.

Improved Review of Inconsistent ResultsSome laboratories have access to a microbiology “expert,”

but this person may not always be available to examine inconsistent results easily.

Through remote access, multiple users can log into the VITEK® 2 computer from anywhere on their laboratory network. Up to 10 users may access the computer remotely at the same time. This will help increase productivity of the testing process, eliminate the need to waste steps going back and forth to check results and allows the opportunity to accomplish tasks within normal working hours. Common tasks include: • View and approve patient isolates in the isolate view• View VITEK® 2 Advanced Expert SystemTM (AES) configuration• Resolve AES conflicts• Validate results which bioART® has stopped for review

If you are interested in capitalizing on the benefits of remote multi-user access, please contact your local bioMérieux sales representative.

bioART™ intelligence simplifies workflow bioART™ is bioMérieux’s Advanced Reporting Tool which allows users to:• Create antibiotic suppression rules• Hold isolates for review• Create customized comments or instructions for each organism situation

bioART ensures quality reporting through predefined rules, such as product limitations or FDA Indications For Use, and allows creation of custom rules to ensure compliance with your institution’s policies and procedures.

These rules are created easily and may be constructed by using the MIC value, interpretation, card type, organism, patient location, patient physician, phenotype, specimen source, specimen type or test results. bioART was designed to be easy to use and to help you save time through efficient processing and validation of organisms tailored to the needs of your institution.

DirectorLab

SatelliteLab

MainLab

Remote Diagnostics & Services

VILINKTM

Gateway

FIREWALL

Simultaneous Multi-user Access

Remote Multiuser Access

* Research Use Only - Not for use in diagnostic procedures.

4

 

 

 

Multiple Instrument ControlThe new software also allows up to four computers to connect to the VITEK® 2 PC. This may help your institution consolidate information onto one computer and reduce the footprint of the system.

Preliminary AST resultsPreliminary results may be reported when they become available before the entire AST card finishes. Preliminary card results may also be expertised by the Advanced Expert System™. By providing preliminary reports to physicians, appropriate clinical decisions may be made earlier, which can have a positive impact on patient care.

MIC suppressionThis feature allows users to suppress an MIC when the final category call does not match the tested MIC value, as in the case of therapeutic or biological corrections. This helps eliminate confusion by allowing microbiologists to suppress the MIC on the chart report in these instances.

Rapid software updates through VILINK®

By implementing the VILINK® computer into your laboratory network you can receive incremental software updates through the Internet. If CLSI makes a change to organism breakpoints, bioMérieux can create new organism updates and provide them to you quickly through the VILINK. VILINK is bioMérieux’s secure solution for remote monitoring and troubleshooting of your VITEK 2 instrument. The VILINK gateway computer allows bioMérieux customer

support to resolve issues remotely and download these software updates.

If you are interested in learning more about the VILINK™gateway, please contact your local bioMéreiux sales representative.

Streamlined QC optionWith the CLSI M50-A changes related to streamlined QC, the software contains the list of organisms for either comprehensive or streamlined QC for Identification cards. Streamlined QC tests a key biochemical reaction in the ID card to ensure that no card degradation has occurred during shipment.

New card options – Streptococci AST cardThis software update will support our Streptococci card. The new AST-ST card will be validated for most major Streptococcal pathogens including S. pneumonia, S. agalactiae, S. pyogenes and a host of other clinically significant species.

Download isolate information The VITEK® 2 Systems software will now be able to receive a downloaded organism identification and beta-lactamase result from a Laboratory Information System (LIS) or OBSERVA®. The downloaded organism identification will automatically link with the AST card when the accession number matches. If the organism identification is not an organism claimed by the AST card, then the organism field will not be populated. There is a new button in the View and Maintain Isolate Results screen that will allow access to the organism identification and beta-lactamase result downloaded from the LIS.

Intelligent software programs have become essential tools that improve the analysis of test results and detection of resistant organisms. PC5.01 is such a tool: This new release is a major leap forward in software-controlled, automated identification and susceptibility instrumentation. A wide range of new features has been added to help you save steps and time.

5bioMérieux Connection July 2011

Robert G. Fowler, MT, (ASCP), CLSHenry Ford HospitalDetroit, MI

Robert G. Fowler, senior lead technologist at the 800-bedHenry Ford Hospital in Detroit always considered the VITEK® 2 the “workhorse” of the hospital’s microbiology lab. “It’s hard to improve a device that already turns around pathogen antibiotic susceptibility results in less than eight hours,” said Fowler. But the new v5.01 upgrade, installed late last year at Henry Ford, has made Fowler a believer that eventhe best instruments can improve.

“Someone in the lab compared the VITEK 2 with the v5.01 upgrade to jumping directly to a smart phone from a rotary dial phone, and I think that’s a very appropriate description,” Fowler said.

The two VITEK 2 units at Henry Ford always have been central to the lab’s antibiotic panels and infectious disease susceptibility testing — including microbial identification with bacteria and yeast identification (ID), antibiotic susceptibility testing (AST) and resistance mechanism detection as well asepidemiologic trending and reporting. However, the old interface presented some challenges for a machine that performs up to 200 tests per day from samples taken at the main hospital and satellite hospitals. According to Fowler, the old “roll and scroll” interface could make it time-consuming to find specific results. Since there was just a single PC in the lab to interface with the two VITEK 2 units, there was often a line of lab scientists waiting to get to their results.

Ease of Use and FlexibilityWith the GUI (Graphic User Interface), working with VITEK 2 has gotten a lot easier and more intuitive. The interface is less text heavy and more graphical, including windows, icons and various menus and buttons allowing the staff at the Henry Ford microbiology lab to find and categorize samples by patients or ID type. The automated software generates a list of unusual patterns for review.

“The Advanced Expert System™ (AES) findings, the ART (Antibiotic Resistance Transferability) comments, the analysis messages and the results are all on the same window so branching to other areas such as from the AES findings to the phenotypic graphical display is just a point and click,” Fowlersaid. “The Navigation tree is very flexible. The view screen has folders for cassettes, patients, bench and date tested.

“VITEK® PC 5.01 — A Welcome Boost to the Microbiology Workhorse”

This fits our needs quite well as our lab has a high volume and is organized by bench. So a tech on respiratory service or urine service can sort by bench folder and review only their own specimens. I can view by date tested, i.e., 5 days ago, which really helps us find those 'stragglers or forgotten' specimens. The filter screens are sorted by the status of the isolate: preliminary, qualified, to be reviewed, etc. Isolates and patients can be searched by accession number or patient number only. All in all, this has been a huge leap forward over the `roll and scroll’ interface.”

Remote ViewerPerhaps Fowler’s favorite new feature is the remote viewer. In February, the lab added a new remote viewer application to the VITEK® 2 system, which allows as many as 10 PCs to interface, search and gather results simultaneously. “This is probably the best feature with our staff,” Fowler said. “Before the Web-based interface, the different benches would batch and hold onto problem specimens until they could get in line and view the single VITEK® 2 PC. That’s no longer a problem.

“I definitely think these improvements will help us better treat patients and improve outcomes,” Fowler added. “The VITEK 2 is an incredibly fast and hands-free machine even without these features. In healthcare, every minute counts. When the lab can provide valuable information quickly, we increase our value in the hospital and among clinicians who depend on this data to treat.”

The Microbiology Lab at Henry Ford installed the VITEK 2 upgrade in preparation for introducing MYLA™ to the microbiology lab. The intelligent microbiology middleware solution is designed by microbiologists formicrobiologists and can provide an actionable,comprehensive picture of lab workflow to rapidly impactpatient management across the full spectrum of microbiology lab equipment.

PC5.01 has been a huge improvement to the lab: the remote viewer feature is greatly appreciated as it suppresses bottlenecks in the lab. Its ease of use and intuitive interface allow for the reduction of multiple steps and is a significant time savings. Finally, the flexibility of the software fits the lab’s needs perfectly.

6

An Inverview with: Allan Foulks, MS, MT (ASCP)Microbiology Laboratory ManagerProfessional Clinical Laboratories, Inc. (ProLab)Fort Worth, TX

When Allen Foulks, the microbiology lab manager at Professional Clinical Laboratories, Inc., (ProLab) in Fort Worth, Texas, installed the first PREVI® Isola in the ProLab network, he expected to see faster turnaround results and improved workflow. He didn’t expect the device to do the work of a full-time equivalent (FTE), save his lab as much as $300 per week on plates, prevent unnecessary hospitalizations and assist nursing homes and long-term care facilities in selecting the best antimicrobial treatments for their patients.

“Unintended consequences are often bad, but they have only been good for us since installing PREVI® Isola in 2010,” Foulks said.

“Rapid and accurate turnaround time is vital for these infections in the elderly. Nursing homes depend on us to get them quick results to save lives and save costs. If the infection is serious, we provide the data that helps them make the best treatment decisions. If the infection is not too serious, we help avert an unnecessary hospitalization for an infection that can be treated within the facility. It’s all about quality care that is cost-effective. We pride ourselves on this service, and the PREVI® Isola has dramatically helped us to achieve this goal.”

“Since making the switch, our workload is heavier on the initial reading due to the better colony isolation,” said Foulks. “But the payoff comes on the second day because greater than 90% of the urine cultures with pathogenic growth are finalized in under 48 hours!”

Urine turnaround times are important in Foulks’ lab. In 2010, the Fort Worth lab ran 107,000 cultures, 88,000 of which were urine cultures. This ratio of urine cultures to total number of cultures is typical for a geriatric patient population. Routine patient testing is done monthly on nursing home patients, including a CBC and urine analysis as mandated by the Joint Commission Patient Safety Guidelines for long-term care facilities. Based on microscopic examination as part of the urine analysis, the lab will perform a culture if indicated.

Geriatric patients often suffer from renal disease and kidney malfunctions, so urine cultures typically contain multiple bacterial isolates in this population. The lab’s protocol for polymicrobial testing is to utilize three plates for all urine samples. The objective is to get a sufficient number of isolated colonies to perform identification and susceptibility testing (ID/AST).

“Prior to the implementation of PREVI Isola, we were able to get a general idea of the number of different organisms by performing gram staining, but we still needed to perform subcultures to obtain pure isolates in order to proceed with the ID/ASTs,” said Foulks. “PREVI Isola trims 24-48 hours from our old process, which ultimately allows physicians to begin appropriate treatment 24-48 hours earlier.”

According to Foulks, only 5% of cultures now require

ProLab is a reference laboratory that caters to nursing homes and acute care hospitals. ProLab has facilities inside acute care hospitals and other locations. The Fort Worth facility that Foulks manages is a centralized microbiology lab that receives all the cultures from remote ProLab facilities throughout the Dallas/Fort Worth area. ProLab has testing facilities in Texas, Oklahoma and Alabama, and currently provides service in Mississippi, Louisiana, Kansas, Georgia and Tennessee.

PREVI® Isola Provides Positive Impact to Laboratory Efficiency and Speeds Valuable Clinical Information to Physicians

7bioMérieux Connection July 2011

subculturing since they’ve implemented the PREVI® Isola. Prior to implementation, the subculturing rate was about 30% when the initial culture was set up using manual plate streaking. This improvement has dramatically reduced turn-around time. Since one-third of ProLab’s urine cultures are polymicrobial, it previously took an extra 1-2 days to get results for 30% of the lab’s urine cultures. Now, 25% of the final culture results are reported in less than 48 hours, so the prime culprits in nursing homes—Escherichia coli, Proteus mirabilis, Staphylococcus aureus—can be found and treated much more quickly.

ProLab’s goal has always been to get results to a long-term care facility prior to the patient being transferred to the hospital. It’s preferable if these patients can be treated within the facility to avoid the stress of a transfer, the risk of exposure to new pathogens and the cost to transfer a patient.

As part of the PREVI Isola evaluation, the lab performed cultures struck manually on 20 samples, all which resulted in no growth. These same samples resulted in the isolation of 35 pathogens when inoculated and plated by the PREVI Isola.

“The added level of confidence provided by the PREVI Isola is a great relief,” said Foulks. “No-growth plates are always a source of second-guessing in the microbiology lab. We often end up manually reculturing no-growth samples, which means an enormous delay in actionable clinical information when they become positive.

The clinical improvements of the PREVI Isola are the most significant benefits of the device,” said Foulks, “but there have been many non-clinical improvements, as well.” Foulks has been able to reallocate 4 hours daily of an FTE onto other more value-added tasks now that manual streaking has been so dramatically reduced. According to Foulks, having staff use this new time on ID/AST testing has been a tremendous improvement.

According to Foulk’s calculations, the PREVI Isola can streak an extra six urine cultures (or 18 plates) every 30 minutes compared to manual streaking. In a small evaluation of the PREVI Isola vs. manual streaking, Foulks’ lab performed 500 urine culture comparisons using both methods. “We saved three hours of an FTE’s time and had better colonization isolation, which resulted in more than 250 organisms effectively worked up with a turnaround time of 24 hours

instead of the typical 72 hours for manual streaking. The results were impressive,” Foulks said.

This improved efficiency had an unexpected result. Foulks calculated a cost savings of $335/week in unused Columbia CNA and MacConkey plates. The additional plates were no longer necessary due to the reduction in the subculturing required when the PREVI® Isola was used to inoculate and plate the original cultures. If the lab can achieve this savings every week, it could achieve a plate cost savings of approximately $17,500 in a single year.

Looking forward, Foulks intends to add positive blood cultures to the lab’s PREVI Isola workload. “The benefits for urine cultures have been undeniable: Reduction of overtime, reallocation of FTE duties for more value-added functions, better colony isolation and improved turnaround time for results. If we can achieve this improvement across all samples in the lab, we’ll be a much more efficient and valuable partner to our clinicians.”

2011 IAFP Annual MeetingJuly 31-August 3 Milwaukee, WI

International Association forFood Protection®

8

New VITEK® 2 Cards

“TOTAL AST”

The AST Configurator is a user-friendly, interactive tool designed to give microbiologists and clinicians real-time feedback to their AST needs. The AST Configurator allows users to enter their drug(s) of choice (searchable by application or class) into a queue and, with the click of a button, have immediate access to their different VITEK 2 and Etest solutions. Customers also will have the option to download a printable PDF-version of the report.

Whether you are a new VITEK 2/Etest user curious what the menu has to offer or an experienced VITEK 2/Etest user lookingto add or switch cards with a specific formulary in mind, the AST Configurator will provide the most efficient VITEK 2 andEtest solutions. In addition, pharmacists can use this tool to gain visibility of what testing options are available for therespective drugs on their formulary, adding immediate value to any clinical antibiotic stewardship program, and at zero cost.

As a world leader in in vitro diagnostics, bioMerieux continues to invest in its “total AST” solution, in an on-going effort to live up to its mission of “advancing diagnostics to improve public health.” The power and intelligence of the AST Configurator, combined with VITEK 2 and Etest technologies, offer our customers the most comprehensive and innovative AST solution available. Visit www.totalast.com for more information.

The expanded VITEK® 2 menu now includes 20 Gram Negative (GN) cards with an array of new antibiotic combinations, the XN04 extension card that mates to the GN45 card, and the new Yeast susceptibility card.

Select GN cards feature a new and improved formulation of Meropenem, which allows for better detection of Carbapenemase producers. In addition, the new Meropenem formulation is cleared for testing Acinetobacter species, which was a limitation on the previous Meropenem formulation. The XN04 extension card mates with the GN45 card and provides 18 additional antibiotics, including Doripenem and the new formulation of Meropenem. Finally, the new FDA-cleared Yeast susceptibility YS05 card provides rapid and automated antifungal susceptibility (AFST) results for Fluconazole, Voriconazole and Caspofungin; this is an upgrade from the current YS02 card that provides an AFST result only for Fluconazole. With the addition of the YS05 VITEK 2 card, bioMérieux now can offer its customers the flexibility to personalize a complete AFST solution that best fits their clinical needs: use the YS05 card as an automated, 3-drug primary AFST panel and use any of the extensive Etest® options as a secondary AFST panel or upon clinical request.

The complete new menu of VITEK 2 cards, including drugs and item numbers, is now available as of July 5, 2011. Visit www.biomerieux-usa.com for more information.

9bioMérieux Connection July 2011

AST - GN45* (411920) AST- XN04 (410401)Amikacin Amoxicillin/Clavulanic AcidAmpicillin Aztreonam

Ampicillin/Sulbactam CefalotinCefazolin CefotaximeCefepime CefotetanCefoxitin Cefpodoxime

Ceftazidime CeftizoximeCeftriaxone Cefuroxime

Ciprofloxacin DoripenemErtapenem Meropenem (new formula)

ESBL Confirmation Test MoxifloxacinGentamicin Nalidixic AcidImipenem Norfloxacin

Levofloxacin PiperacillinNitrofurantoin Tetracycline

Tobramycin TicarcillinTrimethoprim/Sulfamethoxazole Ticarcillin/Clavulanic Acid

Tigecycline

AST - GN46 (411924) AST - GN47 (411923)Amikacin AmikacinAmpicillin Ampicillin

Ampicillin/Sulbactam Ampicillin/SulbactamCefazolin AztreonamCefepime CefazolinCefoxitin Cefepime

Ceftazidime CeftriaxoneCeftriaxone Ciprofloxacin

Ciprofloxacin ErtapenemDoripenem ESBL Confirmation TestErtapenem Gentamicin

ESBL Confirmation Test ImipenemGentamicin Meropenem (new formula)Imipenem Moxifloxacin

Levofloxacin NitrofurantoinNitrofurantoin Tigecycline

Tobramycin TobramycinTrimethoprim/Sulfamethoxazole Trimethoprim/Sulfamethoxazole

AST - GN48 (412090) AST - GN49 (412091)Amikacin Amoxicillin/Clav.acid

Ampicillin/Sulbactam AmpicillinCefepime Cefalotin

Cefotaxime CefazolinCeftazidime CefepimeCeftriaxone Ceftriaxone

Ciprofloxacin CefuroximeGentamicin CiprofloxacinImipenem Ertapenem

Levofloxacin ESBL ConfirmMeropenem GentamicinPiperacillin ImipenemTetracycline LevofloxacinTicarcillin Nitrofurantoin

Ticarcillin/Clav. Acid PiperacillinTigecycline TetracyclineTobramycin Tobramycin

Trimethoprim/Sulfa Trimethoprim/Sulfa

AST - GN50 (412100) AST - GN51 (412101) AST - GN52 (412105)Amoxicillin/Clavulanic Acid Amikacin Amikacin

Ampicillin Ampicillin AmpicillinAztreonam Ampicillin/Sulbactam Ampicillin/SulbactamCefalotin Cefazolin CefazolinCefazolin Cefepime CefepimeCefepime Cefoxitin CefoxitinCefoxitin Ceftazidime Ceftazidime

Cefpodoxime Ceftriaxone CeftriaxoneCeftazidime Ciprofloxacin CiprofloxacinCeftriaxone ESBL Confirmation Test ErtapenemCefuroxime Gentamicin ESBL Confirmation Test

Ciprofloxacin Imipenem GentamicinGentamicin Levofloxacin ImipenemLevofloxacin Meropenem (new formula) Levofloxacin

Nitrofurantoin Nitrofurantoin NitrofurantoinNorfloxacin Piperacillin PiperacillinTetracycline Tobramycin TigecyclineTobramycin Trimethoprim/Sulfamethoxazole Trimethoprim/Sulfamethoxazole

Trimethoprim/Sulfamethoxazole

AST - GN53 (412102) AST - GN54 (412099) AST - GN55 (411948)Amikacin Amikacin AmikacinAmpicillin Amoxicillin/Clavulanic Acid Ampicillin

Ampicillin/Sulbactam Ampicillin Ampicillin/SulbactamCefazolin Ampicillin/Sulbactam CefazolinCefepime Aztreonam CefepimeCefoxitin Cefazolin Cefoxitin

Ceftazidime Cefepime CeftazidimeCeftriaxone Cefoxitin Ceftriaxone

Ciprofloxacin Ceftriaxone CiprofloxacinErtapenem Ciprofloxacin Ertapenem

ESBL Confirmation Test Ertapenem ESBL Confirmation TestGentamicin ESBL Confirmation Test GentamicinImipenem Gentamicin Imipenem

Levofloxacin Imipenem MoxifloxacinMeropenem (new formula) Levofloxacin Nitrofurantoin

Nitrofurantoin Nitrofurantoin Ticaracillin/Clavulanic AcidTigecycline Tigecycline Tigecycline

Trimethoprim/Sulfamethoxazole Tobramycin Tobramycin

Trimethoprim/Sulfamethoxazole Trimethoprim/Sulfamethoxazole

AST - GN56 (412027) AST - GN57 (412103) AST - GN58 (412104)Amikacin Amikacin AmikacinAmpicillin Amoxicillin/Clavulanic Acid AmpicillinCefazolin Ampicillin Ampicillin/SulbactamCefepime Cefalotin Cefazolin

Cefotaxime Cefazolin CefepimeCefoxitin Cefepime Cefoxitin

Ceftazidime Ceftazidime CeftazidimeCiprofloxacin Ceftriaxone CeftriaxoneErtapenem Ertapenem Ciprofloxacin

ESBL Confirmation Test Gentamicin ErtapenemGentamicin Levofloxacin ESBL Confirmation TestImipenem Meropenem (new formula) Gentamicin

Levofloxacin Nitrofurantoin ImipenemNitrofurantoin Norfloxacin Levofloxacin

Piperacillin Piperacillin Meropenem (new formula)Tigecycline Tetracycline NitrofurantoinTobramycin Tigecycline Tobramycin

Trimethoprim/Sulfamethoxazole Tobramycin Trimethoprim/Sulfamethoxazole

Trimethoprim/Sulfamethoxazole

AST - GN59 (412028) AST GN60 (412029) AST - GN61 (411943)Amikacin Amikacin AmikacinAmpicillin Amoxicillin/Clavulanic Acid Amoxicillin/Clavulanic Acid

Ampicillin/Sulbactam Ampicillin AmpicillinAztreonam Aztreonam AztreonamCefazolin Cefazolin CefazolinCefepime Cefepime CefepimeCefotetan Ceftriaxone Cefoxitin

Ceftazidime Ciprofloxacin CeftazidimeCeftriaxone Ertapenem CeftriaxoneErtapenem ESBL Confirmation Test Ciprofloxacin

ESBL Confirmation Test Gentamicin ErtapenemGentamicin Imipenem GentamicinLevofloxacin Levofloxacin Levofloxacin

Meropenem (new formula) Meropenem (new formula) Meropenem (new formula)Nitrofurantoin Nitrofurantoin Nitrofurantoin

Tigecycline Tetracycline PiperacillinTobramycin Tobramycin Tobramycin

Trimethoprim/Sulfamethoxazole Trimethoprim/Sulfamethoxazole Tetracycline

Trimethoprim/Sulfamethoxazole

VITEK® 2 GRAM NEGATIVE SUSCEPTIBILITY TEST CARDS

VITEK® 2 Test Cards

10

AST - GN62 (411947) AST - GN63 (412150) AST - GN64 (411949)Amikacin Amikacin Amikacin

Ampicillin/Sulbactam Ampicillin/Sulbactam Amoxicillin/Clavulanic AcidAztreonam Aztreonam AmpicillinCefazolin Cefepime CefazolinCefepime Cefotaxime CefepimeCefoxitin Ceftazidime Cefotaxime

Ceftazidime Ceftriaxone CefoxitinCeftriaxone Ciprofloxacin Ceftazidime

Ciprofloxacin Ertapenem CiprofloxacinErtapenem Gentamicin ESBL Confirmation TestGentamicin Imipenem GentamicinImipenem Levofloxacin Imipenem

Levofloxacin Meropenem (new formula) Meropenem (new formula)Meropenem (new formula) Piperacillin Nitrofurantoin

Nitrofurantoin Ticarcillin/Clavulanic Acid NorfloxacinPiperacillin Tigecycline PiperacillinTigecycline Tobramycin TetracyclineTobramycin Trimethoprim/Sulfamethoxazole Trimethoprim/Sulfamethoxazole

Trimethoprim/Sulfamethoxazole

AST-GP67 (22226) AST-GP68 (22231) AST-GP70 (22340)Ampicillin Amoxicillin Ampicillin

Benzylpenicillin Benzylpenicillin Cefoxitin ScreenCefoxitin Screen Cefotaxime Ciprofloxacin

Ciprofloxacin Ceftriaxone ClindamycinClindamycin Chloramphenicol DaptomycinErythromycin Ertapenem ErythromycinGentamicin Erythromycin Gentamicin

Gentamicin High Level Synergy Levofloxacin Gentamicin High Level SynergyInducible Clindamycin Resistance Linezolid Inducible Clindamycin Resistance

Levofloxacin Meropenem LevofloxacinLinezolid Moxifloxacin Linezolid

Moxifloxacin Ofloxacin MoxifloxacinNitrofurantoin Telithromycin Nitrofurantoin

Oxacillin Tetracycline OxacillinQuinupristin/Dalfopristin Trimethoprim/Sulfamethoxazole Rifampicin

Rifampicin Vancomycin Streptomycin High Level SynergyStreptomycin High Level Synergy Tetracycline

Tetracycline TigeyclineTigecycline Trimethoprim/Sulfamethoxazole

Trimethoprim/Sulfamethoxazole VancomycinVancomycin

AST-GP71 (410750) AST-GP72 (410770)Benzylpenicillin AmpicillinCefoxitin Screen Ampicillin/Sulbactam

Ciprofloxacin BenzylpenicillinClindamycin ChloramphenicolDaptomycin Ciprofloxacin

Erythromycin DaptomycinGentamicin Erythromycin

Inducible Clindamycin Resistance Gentamicin High Level SynergyLevofloxacin LevofloxacinLinezolid Linezolid

Minocycline MinocyclineMoxifloxacin Nitrofurantoin

Nitrofurantoin NorfloxacinOxacillin Quinupristin/Dalfopristin

Quinupristin/Dalfopristin Streptomycin, High level SynergyRifampicin TigecyclineTetracycline VancomycinTigecycline

Trimethoprim/SulfamethoxazoleVancomycin

AST-YS02 (22157) AST-YS05 (411945)Fluconazole Caspofungin

FluconazoleVoriconazole

TOTAL AST

VITEK® 2 GRAM POSITIVE SUSCEPTIBILITY TEST CARDS

VITEK® 2 ANTIFUNGAL SUSCEPTIBILITY TEST CARDS

VITEK® 2 GRAM POSITIVE SUSCEPTIBILITY TEST CARDSVITEK® 2 GRAM NEGATIVE SUSCEPTIBILITY TEST CARDS

VITEK® 2 Test Cards

Handling more testing, more resistance with a need for more effeciency?

Challenge: How can you optimize your algorithm to address these challenges?• Provide clinicians with guidance on treatment options• Promote the responsible use of antibiotics• Provide clinicians and pharmacists with quantitative information to optimize dosage and regimens

Solution: Visit the online AST Configurator Tool and find the best VITEK® 2 and Etest® solution that meets your AST optimization needs.

www.totalast.com

TOTAL AST

Find The Best VITEK® 2 and Etest® Combination to Meet Your Needs.

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bioMérieux Connection is published by bioMérieux, Inc., 100 Rodolphe Street, Durham, NC 27712. Please send address corrections and mailing list additions to biomerieux.connection@na.biomerieux.com. For customer service, call toll free 800-682-2666. Please visit our web site at www.biomerieux-usa.com. Please share your comments and suggestions with us through your local account manager or by emailing us at the address above. As always, we thank you for being a bioMérieux customer.

100 Rodolphe Street, Durham, North Carolina 27712

www.biomerieux.com

ADDRESS SERVICE REQUESTED

EVEN

TS C

ALEN

DAR

AUG

UST

JULY

15-21 KSU Food Workshop

Date Event & Location

15-17 Lab Plus

2 HPG Vendor Fair and Conference, Nashville, TN

7-10 Southwest Association of Clinical Microbiology (SWACM), Oklahoma City, OK

7-10 Intermountain State Seminar (IMSS), Snow King Resort, Jackson Hole, WY

19-22 PDA/FDA, Renaissance Hotel, Washington, DC

25 ICAHN 4th Annual Vendor Fair, Springfield, IL

30 WVA SCACM

22-23 18th Annual Beaumont Symposium, Troy, MI

31-Aug 3 International Association of Food Protection (IAFP) Milwaukee, WI

10-11 Cardinal Health National Sales Meeting, Las Vegas, NV

SEPT

EMBE

R

National Regional