VITEK GRAM NEGATIVE SUSCEPTIBILITY (GNS) CARD FOR MOXIFLOXACIN

K043237 · bioMerieux, Inc. · LON · Dec 23, 2004 · Microbiology

Device Facts

Record IDK043237
Device NameVITEK GRAM NEGATIVE SUSCEPTIBILITY (GNS) CARD FOR MOXIFLOXACIN
ApplicantbioMerieux, Inc.
Product CodeLON · Microbiology
Decision DateDec 23, 2004
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 866.1645
Device ClassClass 2
AttributesAI/ML

AI Performance

OutputAlgorithmAcceptanceObservedDev DSDev ReadersTest DSTest Readers
Antimicrobial susceptibility of Enterobacteriaceae to moxifloxacinRegression analysis and discriminate analysis98.7% Category AgreementClinical study at three sites including fresh clinical isolates, stock isolates, and a challenge set

Indications for Use

The VITEK® Gram Negative Susceptibility Test is intended to be used with the VITEK® System for the automated quantitative or qualitative susceptibility testing of isolated colonies for the most clinically significant aerobic gram-negative bacilli, Staphylooocus spp., Enterococcus spp., Streptococcus agalactiae, and S. pneumoniae. VITER® Gram Negative Moxifloxacin is designed for antimicrobial susceptibility testing of Klebsiella pneumoniae, Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, and Proteus mirabilis. VITEK Gram Negative Moxifloxacin is for qualitative testing only. It is intended for use with the VITEK System as a laboratory aid in the determination of in vitro susceptibility to antimicrobial agents.

Device Story

VITEK® Gram Negative Susceptibility Card; 45-well test card; used with VITEK® System. Input: isolated bacterial colonies diluted in saline. Process: vacuum-filled card incubated 6-15 hours; optical scanner monitors turbidity hourly; regression and discriminate analysis algorithms determine susceptibility. Output: qualitative SIR (Susceptible, Intermediate, Resistant) interpretation. Used in clinical laboratories; automated process requires no handling after inoculation. Benefits: standardized, automated antimicrobial susceptibility testing; aids clinical decision-making for antibiotic therapy.

Clinical Evidence

No clinical data provided; device relies on bench testing for performance validation of antimicrobial susceptibility testing.

Technological Characteristics

Automated susceptibility test card for use with the VITEK System. Contains moxifloxacin at concentrations of 2, 4, and 8 µg/ml with a calling range of ≤0.5 to ≥8 µg/ml. Operates via the VITEK automated platform for in vitro diagnostic use.

Indications for Use

Indicated for qualitative susceptibility testing (SIR) of Enterobacteriaceae to moxifloxacin (2, 4, 8 µg/mL) using the VITEK® Gram Negative Susceptibility Card. Prescription use only.

Regulatory Classification

Identification

A fully automated short-term incubation cycle antimicrobial susceptibility system is a device that incorporates concentrations of antimicrobial agents into a system for the purpose of determining in vitro susceptibility of bacterial pathogens isolated from clinical specimens. Test results obtained from short-term (less than 16 hours) incubation are used to determine the antimicrobial agent of choice to treat bacterial diseases.

Special Controls

*Classification.* Class II (special controls). The special control for this device is FDA's guidance document entitled “Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems; Guidance for Industry and FDA.”

Submission Summary (Full Text)

{0} 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ASSAY ONLY TEMPLATE A. 510(k) Number: k043237 B. Purpose for Submission: Addition of moxifloxacin to the Vitek® Antimicrobial Susceptibility Test (AST) System C. Measurand: Moxifloxacin 2 – 8 µg/mL D. Type of Test: Qualitative AST growth based detection E. Applicant: bioMerieux, Inc. F. Proprietary and Established Names: VITEK® Gram Negative Susceptibility Card G. Regulatory Information: 1. Regulation section: 21 CFR 866.1645 Fully Automated Short-Term Incubation Cycle Antimicrobial Susceptibility System 2. Classification: II 3. Product code: LON System, Test, Automated, Antimicrobial Susceptibility, Short Incubation 4. Panel: 83 Microbiology H. Intended Use: 1. Intended use(s): The VITEK® Antimicrobial Susceptibility Test is intended to be used with the VITEK® System for the automated quantitative or qualitative susceptibility testing of isolated colonies for most clinically significant aerobic gram-negative bacilli, Staphylococcus spp., Enterococcus spp., Streptococcus agalactiae, and S. pneumoniae. {1} Page 2 of 6 The VITEK® Gram Negative Susceptibility Card is intended for use with the VITEK® system in clinical laboratories as an in vitro test to determine the susceptibility of rapidly growing aerobic and/or facultatively anaerobic, gram-negative bacilli to antimicrobial agents when used as instructed in the “pinsert” and operator’s manual. 2. Indication(s) for use: This submission is for the addition of the antibiotic moxifloxacin at concentrations of 2, 4, and 8 ug/ml for a calling range of ≤ 0.5 – ≥ 8 ug/mL on the VITEK® Gram Negative Susceptibility Card to provide qualitative results (SIR) for Enterobacteriaceae only. 3. Special conditions for use statement(s): For prescription use only Qualitative SIR reading only, MIC results not available 4. Special instrument requirements: N/A I. Device Description: Each VITEK® test card contains 45 wells. The positive control well determines organism growth without antimicrobial inhibition. A suspension of the isolate to be tested is diluted with 0.45 – 0.5% sterile saline. The VITEK® Card is inoculated with the diluted suspension using a vacuum filling process in the VITEK® Filling Module. After the card is inoculated and placed inside the VITEK® Reader/Incubator, no further handling is required. Organism growth inside the card is optically monitored throughout the 6 – 15 hour incubation cycle. J. Substantial Equivalence Information: 1. Predicate device name(s): VITEK® Gram Negative Susceptibility Card for Gatifloxacin 2. Predicate 510(k) number(s): k032711 3. Comparison with predicate: {2} | Similarities | | | | --- | --- | --- | | Item | Device | Predicate | | Intended Use | Determine antimicrobial susceptibility to antimicrobial agents | Same | | Test Organism | Gram Negative Bacilli | Same | | Test Card | VITEK® card format with base broth | Same | | Instrument | VITEK® System | Same | | Differences | | | | --- | --- | --- | | Item | Device | Predicate | | Antibiotic | Moxifloxacin at specific concentrations | Gatifloxacin at specific concentrations | | Reading algorithm | Unique for moxifloxacin | Unique for gatifloxacin | # K. Standard/Guidance Document Referenced (if applicable): "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test Systems; Guidance for Industry and FDA"; NCCLS M7 (M100-S14) "Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically; Approved Standard." # L. Test Principle: The VITEK® System determines when a well demonstrates growth (positive) based on the attenuation of light measured by optical scanner. Organism growth is expressed as increased turbidity in wells. Optical measurements are taken on an hourly basis. If during the 6 - 15 hour incubation cycle, bacterial growth occurs at levels equal to or greater than a predetermined threshold, regression analysis is utilized, along with the organism's identification, to determine the appropriate MIC value for the antimicrobial. The VITEK® Susceptibility Card test is based on the microdilution minimum inhibitory concentration technique with concentrations equivalent to standard method concentrations. Several parameters based on the growth characteristics observed are used to provide appropriate input for calculations. Discriminate analysis is used to develop the algorithm that determines the susceptibility result for all antimicrobials on the VITEK® system. An algorithm of using the 3 dilutions on the card allows for a calling range of $\leq 0.5 - \geq 8\mu \mathrm{g / mL}$ . The AST result must be linked to organism identification in order to determine a category interpretation. A category interpretation (SIR) will be reported. # M. Performance Characteristics (if/when applicable): # 1. Analytical performance: {3} Page 4 of 6 a. Precision/Reproducibility: Ten gram-negative on-scale organisms were tested three times at three sites to determine within site and site to site reproducibility demonstrating >95% reproducibility. b. Linearity/assay reportable range: Not applicable c. Traceability, Stability, Expected values (controls, calibrators, or methods): The recommended QC isolates were tested on every test occasion with the reference method and the VITEK®. The expected range for the E. coli with the reference method was ≤0.25 μg/mL and QC results were in range for every day tested. The expected range for the E. coli with the VITEK® was ≤ 0.50 μg/mL and was tested a sufficient number of times to demonstrate that the system can produce QC results in the recommended range. The mode for the Vitek® was different for the P. aeruginosa however, all results were still within the expected range. This demonstrated a slight trend for the Vitek® to be one dilution more resistant than the reference method result but P. aeruginosa is not included for testing and reporting but it provides on-scale results for QC. Quality Control Table | ORGANISM | Vitek® Conc. | Vitek® | Reference Conc. | Reference | | --- | --- | --- | --- | --- | | | | | | | | E. coli | ≤0.50 | 68 | ≤0.25 | 68 | | ATCC 25922 | 1 | | 0.50 | | | Expected Range: | 2 | | 1 | | | ≤0.06 μg/ml | 4 | | 2 | | | | | | | | | P. aeruginosa | 1 | | 1 | | | ATCC 27853 | 2 | 17 | 2 | 68 | | Expected Range: | 4 | 48 | 4 | 1 | | 1 - 8 μg/ml | 8 | 4 | 8 | | | | | | | | Inoculum density control was monitored using a colorimeter and colony count. This was standardized weekly with all results recorded and in the expected range. Verification was performed during internal testing. A 0.5 McFarland is used to determine the correct inoculum. Colony counts were performed periodically at each site to demonstrate that the inoculum procedure results were in the expected CFU/ml. d. Detection limit: Not Applicable {4} Page 5 of 6 e. Analytical specificity: Not Applicable f. Assay cut-off: Not Applicable 2. Comparison studies: a. Method comparison with predicate device: A clinical study was conducted at three sites using the VITEK® gram negative cards with moxifloxacin and the reference agar dilution method as recommended by the NCCLS. Inoculum was prepared with direct colony suspension. The testing included both fresh clinical isolates and stock isolates along with a challenge set with known results. The test device had a growth rate of >90%. Essential agreement was not calculated because the Vitek card contained <5 dilutions of moxifloxacin. A comparison was provided to the reference method with the following agreement. Summary Table for Enterobacteriaceae spp. | | CA Tot | CA N | CA % | #R | Min | maj | vmj | | --- | --- | --- | --- | --- | --- | --- | --- | | Clinical | 301 | 298 | 99.0 | 22 | 3 | 0 | 0 | | Challenge | 77 | 75 | 97.4 | 11 | 2 | 0 | 0 | | Combined | 378 | 373 | 98.7 | 33 | 5 | 0 | 0 | CA-Category Agreement R-resistant isolates min- minor discrepancies maj-major discrepancies vmj-very major discrepancies CA is when the interpretation of the reference method agrees exactly with the interpretation of the VITEK® results. 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: {5} Page 6 of 6 Not Applicable 5. Expected values/Reference range: Enterobacteriaceae ≤ 2 (S), 4 (I), ≥8 (R) The Interpretative criteria, QC isolates and the expected ranges are the same as recommended by the NCCLS and the FDA. All values will be included in the package insert. N. Proposed Labeling: The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10. O. Conclusion: 1. The submitted information in this premarket notification is complete and supports a substantial equivalence decision.
Innolitics

Panel 1

/
Ready

Predicate graph will load when search results are available.

Embedding visualization will load when search results are available.

PDF viewer will load when search results are available.

Loading panels...

Select an item from Submissions

Click any panel, subpart, regulation, product code, or device to see details here.

Section Matches

Results will appear here.

Product Code Matches

Results will appear here.

Special Control Matches

Results will appear here.

Loading collections...