SENSITITRE HAEMOPHILUS/STREPTOCOCCUS PNEUMONIAE (HP) MIC PLATES

K032382 · Trek Diagnostic Systems, Inc. · JWY · Aug 29, 2003 · Microbiology

Device Facts

Record IDK032382
Device NameSENSITITRE HAEMOPHILUS/STREPTOCOCCUS PNEUMONIAE (HP) MIC PLATES
ApplicantTrek Diagnostic Systems, Inc.
Product CodeJWY · Microbiology
Decision DateAug 29, 2003
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 866.1640
Device ClassClass 2

Indications for Use

The Sensititre® Haemophilus influenzae/Streptococcus pneumoniae plates are in vitro diagnostic products for clinical susceptibility testing of Haemophilus influenzae, Streptococcus pneumoniae and other fastidious isolates. The addition of gemifloxacin in the dilution range of 0.001 -16 ug/ml to the Sensititre® Haemophilus/Streptococcus pneumoniae (HP) MIC Susceptibility plate MIC panel is for testing Haemophilus influenzae and Streptococcus pneumoniae isolates.

Device Story

Sensititre® HP MIC Susceptibility plates are multi-well plastic microtitre plates containing dried, stabilized antimicrobics. Device tests susceptibility of H. influenzae and S. pneumoniae to gemifloxacin. Inoculum prepared from colonies via direct inoculation method (0.5 McFarland). Plates incubated 18-24 hours. Growth detection via fluorescence (Autoread system) or visual observation of lowest dilution inhibiting growth. Output is Minimum Inhibitory Concentration (MIC) value. Used in clinical laboratory settings. Results assist clinicians in determining appropriate antibiotic therapy for fastidious bacterial infections.

Clinical Evidence

Performance evaluated via clinical and challenge studies at two sites comparing Sensititre® manual/automated readings to NCCLS broth reference method. S. pneumoniae (n=288): 99.3% EA, 98.6% CA. H. influenzae (n=262): 97.7% EA, 100% CA. Reproducibility testing performed with 10 isolates per species across two sites. Quality control performed using ATCC strains. Results showed acceptable performance despite minor trending differences between manual and automated read methods.

Technological Characteristics

Multi-well plastic microtitre plates; dried, stabilized antimicrobics. Sensing principle: fluorescence detection of bacterial growth (automated) or visual observation of growth inhibition. Energy source: electrical (for Autoread system). Dimensions: standard microtitre plate format. Connectivity: standalone or integrated with Sensititre Autoread system. Sterilization: not specified.

Indications for Use

Indicated for clinical susceptibility testing of Haemophilus and Streptococcus pneumoniae isolates to Gemifloxacin in patients with infections caused by these organisms.

Regulatory Classification

Identification

An antimicrobial susceptibility test powder is a device that consists of an antimicrobial drug powder packaged in vials in specified amounts and intended for use in clinical laboratories for determining in vitro susceptibility of bacterial pathogens to these therapeutic agents. Test results are used to determine the antimicrobial agent of choice in the treatment of bacterial diseases.

Submission Summary (Full Text)

{0} 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY DEVICE ONLY TEMPLATE A. 510(k) Number: k032382 B. Analyte: Gemifloxacin (0.001 -16 ug/ml) C. Type of Test: Quantitative Antimicrobial Susceptibility Test (AST) growth based fluorescence D. Applicant: TREK Diagnostic Systems, Inc. E. Proprietary and Established Names: Sensititre® Haemophilus/Streptococcus pneumoniae (HP) MIC Plates F. Regulatory Information: 1. Regulation section: 866.1640 Antimicrobial Susceptibility Test Powder 2. Classification: II 3. Product Code: JWY-manual readings of AST testing of &gt;16 hour incubation LRG Automated readings of AST of &gt;16 hour incubation. 4. Panel: 83 Microbiology G. Intended Use: 1. Intended use(s): The Sensititre® Haemophilus influenzae/Streptococcus pneumoniae plates are in vitro diagnostic products for clinical susceptibility testing of Haemophilus influenzae, Streptococcus pneumoniae and other fastidious isolates. 2. Indication(s) for use: The addition of gemifloxacin in the dilution range of 0.001 -16 ug/ml to the Sensititre® Haemophilus/Streptococcus pneumoniae (HP) MIC Susceptibility plate MIC panel is for testing Haemophilus influenzae and Streptococcus pneumoniae isolates. 3. Special condition for use statement(s): S. pneumoniae are diluted in lysed horse blood for a final concentration of 2-5% and the Haemophilus influenzae are diluted in Haemophilus Test Medium (HTM) 4. Special instrument Requirements: Not applicable H. Device Description: Sensititre® Haemophilus/Streptococcus pneumoniae (HP) MIC Susceptibility plate MIC panels are multi-well plastic microtitre plates, precision dosed with dried, stabilized antimicrobics. I. Substantial Equivalence Information: {1} Page 2 of 5 1. Predicate device name(s): Pasco MIC and MIC/ID Panels 2. Predicate K number(s): k032259 3. Comparison with predicate: | Similarities | | | | --- | --- | --- | | Item | Device | Predicate | | Intended use | same | same | | Inoculum | Prepared from colonies using the direct inoculation method | Prepared from colonies using the direct inoculation method | | Inoculation method | Direct equated to a 0.5 McFarland | Direct equated to a 0.5 McFarland | | Incubation | 18-24 hours | 18-24 hours | | Item | Device | Predicate | | Type panel | Dried antibiotics | 100 μl/well frozen | | Technology | Fluorescence detection of growth | Turbidity detection of growth | | Reading method | Visual growth and Auto read by instrumentation | Visual growth | J. Standard/Guidance Document Referenced (if applicable): "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems; Guidance for Industry and FDA"; NCCLS M7 (M100-S13) "Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically; Approved Standard" K. Test Principle: The Sensititre Autoread System utilizes fluorescence technology to read 18-24 hour plates. The Sensititre manual system for MIC's is determined by observing the lowest dilution of antimicrobial agent that inhibits growth of the organism. L. Performance Characteristics (if/when applicable): 1. Analytical performance: a. Precision/Reproducibility: Reproducibility testing was performed at only two sites following a very old version of the AST guidance document. Ten S. pneumoniae and 10 H. influenzae were tested three times at each site. All isolates had on scale results at all times. The S. pneumoniae readings were done both manually and by the Autoread method. All studies had acceptable results with one site having a slight trend to a one well more susceptible result with the Autoreader. b. Linearity/assay reportable range: Not applicable c. Traceability (controls, calibrators, or method): {2} | ORGANISM | Conc ug/ml | Reference | Sensititre® Auto | Sensititre® manual | | --- | --- | --- | --- | --- | | S. pneumoniae ATCC 49619 Range 0.008-0.03 ug/ml | <0.008 | | | | | | 0.008 | 7 | 18 | 1 | | | 0.015 | 33 | 22 | 37 | | | 0.03 | | 1 | 3 | | | >0.03 | 1 | | | | | | | | | | H. influenzae ATCC 49247 Range 0.002-0.008 ug/ml | <0.002 | | | | | | 0.002 | | | | | | 0.004 | 37 | | 38 | | | 0.008 | 3 | | 1 | | | >0.008 | | | 1 | Quality control was performed at both sites using both the manual read method and the Autoread method. The Autoreads again had a trend to a more susceptible reading than the manual readings. This was more apparent at one site. Nephelometer was used at each site to standardize the inoculum and it was calibrated each time it was switched on. d. Detection limit: Not applicable e. Analytical specificity: Not applicable f. Assay cut-off: Not applicable # 2. Comparison studies: a. Method comparison with predicate device: A clinical study was performed at two sites with the Sensititre® test panels and compared to the NCCLS broth reference method. The S. pneumoniae and the H. influenzae isolates were read by the manual method of reading while the S. pneumoniae isolates were also read using the Autoreader. S. pneumoniae data manual reading | | total | EA | %EA | Total evaluable | EA of evaluable | %EA | CA | %CA | #R | min | maj | vmj | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Clinical | 234 | 232 | 99.1 | 234 | 232 | 99.1 | 230 | 98.3 | 3 | 4 | 0 | 0 | | Challenge | 54 | 54 | 100 | 54 | 54 | 100 | 54 | 100 | 0 | 0 | 0 | 0 | | Combined | 288 | 288 | 99.3 | 288 | 286 | 99.3 | 284 | 98.6 | 3 | 4 | 0 | 0 | The S. pneumoniae Autoread results were very similar to the manual readings with acceptable EA, CA and error rates for both methods of reading. One observation of the results was the difference in the trending of the results as compared to the reference method. The {3} manual results trended to a slightly more resistant result (one well) while the Autoreads trended to a slightly more susceptible reading (one well) than the reference method. H. influenzae data manual readings | | total | EA | %EA | Total evaluable | EA of evaluable | %EA | CA | %CA | #R | min | maj | vmj | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Clinical | 212 | 207 | 97.6 | 208 | 203 | 97.6 | 212 | 100 | 0 | 0 | 0 | 0 | | Challenge | 50 | 49 | 98 | 50 | 49 | 98 | 50 | 100 | 0 | 0 | 0 | 0 | | Combined | 262 | 256 | 97.7 | 258 | 252 | 97.7 | 262 | 100 | 0 | 0 | 0 | 0 | EA-Essential Agreement CA-Category Agreement R-resistant isolates maj-major discrepancies vmj-very major discrepancies min-minor discrepancies Evaluable results are those that fall within the test range of the reference method and could also be on-scale with the new device if within the plus/minus one well variability. EA is when there is agreement between the reference method and the Sensititre® result within plus or minus one serial two-fold dilution of antibiotic. CA is when the interpretation of the reference method agrees exactly with the interpretation of the Sensititre® result. b. Matrix comparison: Not applicable 3. Clinical studies: a. Clinical sensitivity: Not applicable b. Clinical specificity: Not applicable c. Other clinical supportive data (when a and b are not applicable): Not applicable 4. Clinical cut-off: Not applicable 5. Expected values/Reference range: S. pneumoniae = ≤ 0.12 (S), 0.25 (I), ≥ 0.5 (R) Haemophilus influenzae ≤ 0.12 (S) The current absence of data on resistant strains precludes defining any results other than "Susceptible". Strains yielding MIC results suggestive of a "nonsusceptible" category should be submitted to a reference laboratory for further testing. M. Conclusion: The reproducibility, quality control results and overall performance appears to be acceptable although the recommendations as described in the "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems; Guidance for Industry and FDA" were not used in the design and evaluation of the study. The addition of an additional site would have added more diversity to the selection of isolates and also provide a more statistical valid reproducibility design. The appropriate control organisms are included in the labeling and are the same as those recommended in the NCCLS M7-(M100-S13) document. This performance as compared to a standard method demonstrates substantial equivalency to the predicate. {4} Page 5 of 5
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