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This dissertation, Evaluation of an Automated Microarray-based Molecular Test for Rapid Identification of Drug Resistance Determinants in Bacteria Directly From Positive Blood Culture Broths by Wai-fung, Ivan, Wong, 黃煒豐, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Abstract Bloodstream infection is life-threatening disease which associates with high mortality and morbidity. In order to produce a rapid and accurate blood culture result, Verigene system is developed and targeted on both Gram positive and Gram negative bacteria. This multicenter study evaluated the performance of Verigene on detection of resistance markers by using Blood Culture-Gram Positive Assays (BC-GP) and Blood Culture-Gram Negative Assays (BC-GN). In total, 64 Gram positive and 139 Gram negative contained blood broths were collected from 3 hospitals in Hong Kong including Pamela Youde Nethersole Eastern Hospital, United Christian Hospital and Princess Margaret Hospital. Comparing to gold standard (conventional antibiotic sensitivity test), the performance of resistance marker detection and time needed for final reporting of Verigene were evaluated. In this study, different resistance markers were detected, such as mecA (BC-GP), bla, bla (BC-GN), by Verigene CTX-M OXA system. The discordant results were resolved by multiplex PCR. The overall of resistance markers detection including mecA was excellent especially for BC-GP. Comparing to conventional culture method, 100% (16/16) sensitivity and specificity on detection of mecA in MRSA. Also, 88% (22/25) sensitivity on detection of CTX-M in ESBL producing Gram negative isolates. For BC-GN, there were 3 false negative cases and 1 false positive case in bla detection. By using multiplex PCR, CTX-M 5 bla was detected in all 3 false negative cases while no resistance gene was CTX-M group 9 detected in the false positive case. Verigene provides reliable results on detection of resistance markers on BC-GP and BC-GN. The significant reduction of turnaround time from 48 hours routine methods to 2 hours with same day reporting. The reduction of turnaround time can provide a better therapeutic advice and patient outcome. Subjects: Blood - ExaminationDrug resistance in microorganisms

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