Now you can report species identification together with the Gram Stain ResultsQuick
FISH is a rapid, simple slide based assay that provides a definitive pathogen identification, directly from a positive blood culture in just 20 minutes.
It is ideally suited to providing accurate diagnosis of bacteraemia, candidaemia and sepsis.
This molecular diagnostic platform has been developed by AdvanDx, based on its clinically proven proprietary PNA technology.
This new platform enables unprecedented (20 minute) species identification of bacteria directly from positive blood cultures, allowing the reporting of pathogen identification at the same time as the reporting of Gram stain results.
QuickFISH™ Tests- Simple and Effective
- Market leading turnaround time
- Convenient and easy protocol
- Accurate Pathogen ID
- Provide earlier diagnosis
- Optimise and target antibiotic treatment
- Improve patient care
- Save healthcare costs
Find out more at our dedicated Sepsis Diagnostics website:
Published data demonstrates that the risk of death from septic shock increases by the hour unless appropriate therapeutic intervention occurs.
The QuickFISH rapid molecular diagnostic system overcomes these issues by enabling a positive species identification to be obtained from a positive blood culture in just 20 minutes.
This allows the pathogen identity to be reported to the clinician at the same time as the gram stain results- 2 days earlier than using conventional methods. Providing this information permits appropriate antimicrobial therapy to commence promptly, potentially resulting in enhanced patient outcomes. In addition the ability to identify possible misleading contaminants, such as coagulase negative Staphylococci (CNS), allows treatment to be promptly de-escalated where necessary, with attendant resource savings.
QuickFISH™ for Pathogen Identification
The panel of QuickFISH tests for rapid identification of bacteria and yeast directly from positive blood cultures cover pathogens responsible for the majority of bloodstream infections and found in more than 85% of positive blood cultures, including Staphylococcus and Enterococcus. Assays for additional clinically important microbial species including Gram-Negative bacteria and Candida are also now available.
These tests present a considerable time saving compared to traditional methods for identifying blood culture pathogens. The innovative QuickFISH system reduces the time to pathogen identification in positive blood cultures by up to 72 hours.
Gram stain dilemmas
Following Gram stain, positive blood cultures may be reported as Gram-positive cocci in clusters (GPCC), Gram-positive cocci in pairs and chains (GPCPC), Gram-negative rods (GNR) or Yeast. Unfortunately this information alone is not always enough to select the most appropriate therapy. GPCC samples may indicate infection with S aureus but could also be indicative of culture contamination with Coagulase NegativeStaphylococcus and not true infection. GPCPC could be E faecalis, E faecium, otherEnterococci or Streptococci presenting treatment dilemmas. Whilst E Faecalis is typically susceptible to ampicillin and Streptococci generally treated with vancomycin, other species of Enterococci are both ampicillin and vancomycin resistant.
Using AdvanDx QuickFISH can rapidly resolve these and other dilemmas using multiplex identification assays.
What would you do differently if you could receive pathogen ID with the Gram stain result?
Quick reference guide:
S aureus/ Coagulase-Negative Staphlococci
- Duplex assays
- S aureus infection (green)
- CoNS positive (red)
- A mixed culture
- Duplex assays
- E.faecalis infection (green)
- E.faecium infection (red)
- A mixed culture
- Optimise patient care
- Reduce mortality rates
- Shorten length of hospital stay
- Lower health care costs
- 5 minutes Hands-on Time – Simplifies and streamlines laboratory workflow.
- 20 minutes Turn-around Time – Fast enough to be reported with Gram stain results.
- Built-in, Universal Controls – Ensures confidence in test results.
- Limited Instrumentation and Capital Investment Required– Easy and inexpensive to implement and start testing.
The QuickFISH system is based on the patented PNA-FISH technology that enhances the well-known technique of Fluorescent In Situ Hybridisation (FISH) by incorporating the use of Peptide Nucleic Acids (PNA). QuickFISH is a rapid, simple slide based assay requiring only 5 minutes hands-on time. It provides a definitive pathogen identification, directly from a positive blood culture, in just 20 minutes.
It is ideally suited to providing accurate diagnosis of bacteraemia, candidaemia and sepsis in the clinical microbiology lab.
QuickFISH compares favourably with biochemical tests, amplification tests and MALDI-TOF. Considering commercially available molecular tests, QuickFISH has the fastest turn around time.1
1. Rapid detection of Enterococcus spp. direct from blood cultures using Enterococcus QuickFISH method: a multicentre investigation. Deck, M.K. et al.
Diagn Microbiol_Infect Dis 2013, j.diagmicrobio. 2013.12.004
1. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Kumar et al.
Chest. 2009 Nov;136(5):1237-48.
2. Rapid detection of Enterococcus spp. direct from blood cultures using Enterococcus QuickFISH method: a multicentre investigation. Deck, M.K. et al.
Diagn Microbiol_Infect Dis 2013, j.diagmicrobio. 2013.12.004
3. Multicenter Evaluation of the Staphylococcus QuickFISH Method for Simultaneous Identification of Staphylococcus aureus and Coagulase-Negative Staphylococci Directly from Blood Culture Bottles in Less than 30 Minutes.
Deck et al, Journal of Clinical Microbiology 50(6) p1994-1998 (2012)
“The method [QuickFISH] has the ability to revolutionize standard testing and reporting protocols for blood cultures”
“Staphylococcus QuickFISH has a turnaround time (TAT) of<30 min and a hands-on time (HOT) of<5 min. The ease and speed of the method have the potential to improve the accuracy of therapeutic intervention by providing S. aureus/CoNS identification simultaneously with Gram stain results.”
“Staphylococcus QuickFISH has the potential to significantly impact individual patient outcomes and overall bloodstream infection treatment costs by providing physicians with information to allow earlier implementation of targeted antibiotic therapies”
“The method provides a presumptive identification of S. aureus and classifies most non-S. aureus staphylococci as CoNS. Clinical trial results demonstrated high sensitivity and specificity for detection of staphylococci in blood cultures and rapid and easy discrimination of S. aureus and CoNS.”
4. Comparison of the Staphylococcus QuickFISH BC Test with the Tube Coagulase Test Performed on Positive Blood Cultures for Evaluation and Application in a Clinical Routine Setting
Caretto et al, Journal of Clinical Microbiology 51(1) p131-135 (2013)
“In our experience the new Quick-FISH appeared quick, reliable, and easy to perform, and it allowed us to reduce Turnaround Time compared with those of the Direct Tube Coagulase Test and traditional PNA-FISH. Using this method, the microbiologist is able to provide the clinicians with the results of both Gram stain and the presumptive identification of Staphylococcus aureus in half an hour from the bottle positivity.”
“It has to be emphasized that the hands-on time of the QuickFISH Test is less than 5 min; the technique is easy, and the slides can be prepared by technicians after only a short training period. The introduction of the method in the laboratory routine therefore has a low implication in modifying the usual workflow. In conclusion, the QuickFISH technology appears robust and reliable, with the major advantage of providing results in half an hour. It can be expected that this technique will be used routinely for all blood cultures”
5. 20-minute identification of enterococci and Staphylococcus aureus causing bloodstream infections by QuickFISH™, a novel assay based on PNA technology
Poster # P-2373. ECCMID 2012. F. Wu, S. Whittier, M. Fiandaca, B. Crystal, P. Della-Latta
“This study evaluated the accuracy of Staphylococcus QuickFISH and EnterococcusQuickFISH (AdvanDx), in differentiating S. aureus from CoNS and E. faecalis from non-E. faecalis enterococci, respectively, directly from BC in ~20 minutes. These assays have the potential to improve appropriate use of antibiotics and patient care.”
6. Rapid QuickFISH compared to standard PNA FISH for identifcation of S. aureus and CNS.
Poster # P-1499. ECCMID 2012. Lene Leerbeck, Dennis Schroder Hansen Department of Clinical Microbiology, Hillerod Hospital Denmark
“Staphylococcus QuickFISH provides accurate identification of S. aureus and CNS species directly from positive blood cultures. The test workflow integrates well with standard Gram stain procedure and provides results in 20-30 minutes, enabling the simultaneous reporting of Gram stain and species ID to the treating physician.”
7. Evaluation of the QuickFISH BC test, A rapid method to distinguish Staphylococcus aureus from coagulase-negative staphylococci in positive blood cultures.
Poster. ECCMID 2012. E. Carretto, M. Mirra, M. Bardaro, S. Ferretti, C. Zuelli
“In our experience the procedure appeared quick, reliable and easy to perform. Its performance in distinguishing SA and CNS was very good”
“An excellent agreement between QFT and a standard laboratory technique such as DTCT was demonstrated. Although the latter is cheaper, its sensitivity was lower compared with QFT. Moreover, the DTCT, even after the 4h analysis, is completely useless if performed late in the afternoon, because the results would be available only after the Laboratory is closed”
Based on PNA FISH (Peptide Nucleic Acid Fluorescence In Situ Hybridisation) technology,QuickFISH uses fluorescent-labelled probes to target species-specific rRNA sequences in a highly sensitive and specific Fluorescence in situ hybridisation assay.
There is no need for further amplification or cell lysis to isolate genetic material as the PNA probes hybridise to rRNA inside the bacteria, enabling whole cell analysis.
QuickFISH uses PNA probes with paired quencher molecules. During hybridisation the probe separates from the quencher and is free to bind target rRNA in the sample. On cooling, unbound probe will reform probe-quencher complexes.
This eliminates the wash step required with the original PNA FISH assay, aiding convenience and reducing turn around time.
A sample of the positive culture can be fixed, hybridised, mounted and read with a fluorescent microscope in under 30 mins with minimal hands on processing time.
QuickFISH assay kits should be used together with QuickFISH Fixation Kits (QFFIXBC1-50, QFFIXBC1-25) which contain fixation reagents and QuickFISH slides. Results should be read using the AdvanDx Microscope Filter (AC007).
A QuickFISH starter system containing microscope filters, slide station, mixing station and 10µl fixed volume pipette is also available (ST004).
QuickFISH assays are not suitable for use with blood culture tubes containing charcoal as an antimicrobial removal device.