BD PHOENIX AUTOMATED MICROBIOLOGY SYSTEM -AMPICILLIN-SULBACTAM (GN) 0.5/0.25-32/16UG/ML

K043389 · Becton, Dickinson & CO · LON · Jan 21, 2005 · Microbiology

Device Facts

Record IDK043389
Device NameBD PHOENIX AUTOMATED MICROBIOLOGY SYSTEM -AMPICILLIN-SULBACTAM (GN) 0.5/0.25-32/16UG/ML
ApplicantBecton, Dickinson & CO
Product CodeLON · Microbiology
Decision DateJan 21, 2005
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 866.1645
Device ClassClass 2

Indications for Use

The BD Phoenix™ Automated Microbiology System is intended for the rapid identification and in vitro antimicrobial susceptibility testing of isolates from pure culture of most aerobic and facultative anaerobic gram-negative and gram-positive bacteria of human origin.

Device Story

The BD Phoenix System is an automated microbiology platform for rapid identification and antimicrobial susceptibility testing (AST) of bacterial isolates. The system utilizes molded polystyrene panels containing biochemicals and antimicrobial agents. Inputs consist of pure culture bacterial isolates inoculated into Phoenix ID or AST broth at a 0.5 McFarland standard. The system uses a redox indicator and turbidity measurements to detect bacterial growth in the presence of antimicrobial agents. The instrument continuously incubates panels at a nominal temperature, performing readings every 20 minutes. Software interprets these readings to provide MIC values and categorical interpretations (S, I, or R). Used in clinical microbiology laboratories by trained technicians. The output assists clinicians in selecting appropriate antibiotic therapy by determining the susceptibility profile of the patient's bacterial isolate, potentially improving patient outcomes through targeted treatment.

Clinical Evidence

Performance evaluated using clinical, stock, and challenge isolates. Study compared Phoenix System results to NCCLS reference broth microdilution method. For ampicillin-sulbactam, 1052 isolates were tested, achieving 88.3% Category Agreement. Reproducibility studies at three sites demonstrated >90% intra-site and >95% inter-site reproducibility.

Technological Characteristics

Automated microbiology system using colorimetric oxidation-reduction redox indicator. Materials: molded polystyrene trays with 136 micro-wells. Energy: thermal (35°C incubation). Connectivity: barcode scanning, automated instrument processing. Software: rule-based 'EXPERT' system for result interpretation. Inoculum: 5 × 10⁵ CFU/ml final concentration in cation-adjusted Mueller-Hinton broth with 0.01% Tween 80.

Indications for Use

Indicated for in vitro rapid identification and quantitative antimicrobial susceptibility testing (MIC) of gram-negative aerobic and facultative anaerobic bacteria (Enterobacteriaceae and non-Enterobacteriaceae). This submission adds ampicillin-sulbactam (0.5/0.25–32/16 ug/mL) for Enterobacteriaceae. Proteus spp. and Acinetobacter spp. are excluded.

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.”

Predicate Devices

Submission Summary (Full Text)

{0} 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ASSAY ONLY TEMPLATE A. 510(k) Number: K043389 B. Purpose for Submission: To add ampicillin-sulbactam to the Gram-Negative ID/AST or AST only Phoenix™ panels C. Measurand: Ampicillin-sulbactam at concentrations between 0.5/0.25 to 32/16 ug/mL D. Type of Test: Antimicrobial Susceptibility Test (Quantitative and qualitative) colorimetric oxidation-reduction, growth-based E. Applicant: Becton, Dickinson &amp; Company F. Proprietary and Established Names: BD Phoenix™ Automated Microbiology System – ampicillin-sulbactam- Gram Negative G. Regulatory Information: 1. Regulation section: 21 CFR 866.1645 Fully Automated Short-Term Incubation Cycle Antimicrobial 2. Classification: Class II 3. Product Code: LON {1} 4. Panel: 83 Microbiology H. Intended Use: 1. Intended use(s): BD Phoenix™ Automated Microbiology System: The BD Phoenix™ Automated Microbiology System is intended for in vitro quantitative determination of antimicrobial susceptibility by minimal inhibitory concentration of gram-negative aerobic and facultative anaerobic bacteria belonging to the family Enterobacteriaceae and non-Enterobacteriaceae and gram-positive bacteria belonging to the genera Staphylococcus and Enterococcus. The BD Phoenix™ GN Panel: The BD Phoenix™ Automated Microbiology System is intended for the in vitro rapid identification (ID) and quantitative determination of antimicrobial susceptibility by minimal inhibitory concentration (MIC) of gram-negative aerobic and facultative anaerobic bacteria belonging to the family Enterobacteriaceae and non-Enterobacteriaceae. 2. Indication(s) for use: This submission is for the addition of the antibiotic ampicillin-sulbactam at concentrations between 0.5/0.25 – 32/16 ug/mL for Enterobacteriaceae testing. 3. Special conditions for use statement(s): Prescription Use Results for Proteus spp. and Acinetobacter spp. have been excluded in the BD Phoenix™ therefore no results will be reported. An alternate method should be performed with these combinations. 4. Special instrument requirements: Not Applicable I. Device Description: The BD Phoenix™ Automated Microbiology System includes instrumentation and software, sealed and self-inoculating molded polystyrene trays with 136 micro-wells containing dried reagents, and specific inoculum broth formulations for ID and AST Indicator. The organism to be tested must be a pure culture and be preliminarily identified as gram positive or gram negative. Colonies are then suspended in broth, and equated to a 0.5 McFarland with the recommendation to use the BD CrystalSpec™ Nephelometer. A further dilution is made into an AST broth, which 2 {2} contains an AST indicator, prior to inoculating the panel. The AST broth is a cation-adjusted formulation of Mueller-Hinton broth containing 0.01% Tween 80. After adding the indicator solution to the AST inoculum the color is blue and after inoculation and incubation goes to pink to colorless as reduction in the panel well proceeds. Inoculated panels are barcode scanned and loaded into the BD Phoenix™ Automated Microbiology System instrument where the panels are continuously incubated at 35°C. The AST has a final inoculum of 5 × 10⁵ CFU/ml. The instrument incubates, reads and records the results of the biochemical substrates and antimicrobial agents and interprets the reactions to give an ID of the isolate and MIC value and category interpretation of the antimicrobial agents. Organisms growing in the presence of a given antimicrobic agent reduce the indicator, signaling organism growth and resistance to the antimicrobic agent. Organisms killed or inhibited by a given antimicrobic do not cause reduction of the indicator and therefore do not produce a color change. Additional interpretation is done using software driven "EXPERT" System with rules derived from the CLSI (Clinical and Laboratory Standards Institute) standards. Readings are taken every 20 minutes with an ID result available between 2-12 hours and an AST result available between 4-16 hours. This is only an autoread result; there are no manual readings possible. ## J. Substantial Equivalence Information: 1. Predicate device name(s): Vitek System® 2. Predicate 510(k) number(s): N50510 3. Comparison with predicate: | Similarities | | | | --- | --- | --- | | Item | Device | Predicate | | Intended use | Intended for the in vitro rapid identification (ID) and quantitative determination of antimicrobial susceptibility by minimal inhibitory concentration (MIC) of gram-negative aerobic and facultative anaerobic bacteria. | same | | Isolates | Isolated colonies from culture used | Isolated colonies from culture used | | Results | Report results as minimum | Report results as | {3} | Similarities | | | | --- | --- | --- | | Item | Device | Predicate | | | inhibitory concentration (MIC) and categorical interpretation (SIR) | minimum inhibitory concentration (MIC) and categorical interpretation (SIR) | | Incubation conditions | <16 hours | <16 hours | | Differences | | | | --- | --- | --- | | Item | Device | Predicate | | Inoculum preparation | Inoculum density equated to 0.5 McFarland standard | Inoculum density equated to 1.0 McFarland standard | | Reading algorithm | Results are determined from serial twofold dilutions of antimicrobial agents | Results are determined from extrapolation of specific dilutions | | Technology | Automated growth based enhanced by use of a redox indicator (colorimetric oxidation-reduction) to detect organism growth. | Automated growth based with detection using an attenuation of light measured by an optical scanner. | # K. Standard/Guidance Document Referenced (if applicable): "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems; Guidance for Industry and FDA"; NCCLS/CLSI M7 (M100-S14) "Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically; Approved Standard." # L. Test Principle: The system employs conventional, colorimetric, fluorogenic and chromogenic substrates to identify the genus and species of the isolate. The AST portion of the BD Phoenix™ Automated Microbiology System is a broth based microdilution method that utilizes a redox indicator (colorimetric oxidation-reduction) to enhance detection of organism growth. The MIC is determined by comparing growth in wells containing serial two-fold dilutions of an antibiotic to the growth in "growth control wells" which contain no antibiotic. # M. Performance Characteristics (if/when applicable): 1. Analytical performance: {4} a. Precision/Reproducibility: Fifteen strains with on-scale results were tested at each of three clinical sites in triplicate on three separate days with results that were reproducible at $\geq 95\%$ . b. Linearity/assay reportable range: Not Applicable c. Traceability, Stability, Expected values (controls, calibrators, or methods): CLSI recommended Quality Control strains were tested (see table below). The full panel was tested each day of testing for both the reference test and the Phoenix™. The table reflects the numbers with the MIC at each concentration. The expected range is stated. The Phoenix results demonstrate that the system can produce QC results in the recommended range. The modes were the same for the Phoenix™ and the reference test result. The Quality Control failure rate is acceptable. | Organism (expected range) | Concentration | Reference results | Phoenix™ results | | --- | --- | --- | --- | | | | | | | E. coli ATCC 25922 (range2/1- 8/4 ug/ml) | ≤0.5/4 | | | | | 1 | | | | | 2 | 32 | 7 | | | 4 | 165 | 189 | | | 8 | 2 | 2 | | | 16 | 1 | 5 | | | 32 | | | | | >32 | | 2 | | | | | | | E. coli ATCC 35218 (range 8/4-32/16 ug/mL) | ≤0.5 | | | | | 1 | | | | | 2 | | | | | 4 | | | | | 8 | | 8 | | | 16 | 149 | 188 | | | 32 | 50 | 4 | | | >32 | | 2 | {5} Inoculum density control: The organism suspension density of the ID broth was equivalent to a 0.5 McFarland standard using the BBL™ CrystalSpec™ Nephelometer which was verified each day of testing. Internal data was used to demonstrate that the use of the BBL™ CrystalSpec™ Nephelometer would produce reproducible results. Five different instruments were used. The overall growth rate was greater than 95%. 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: The CLSI recommended broth dilution reference panel was prepared according to the CLSI recommendation and used to compare with the Phoenix™ results. Clinical testing was performed at four sites. The testing included clinical isolates comprised of fresh, recent and stock isolates. A comparison was provided to the reference method with the following agreement for the Enterobacteriaceae excluding Proteus spp. This table demonstrates the performance of all Enterobacteriaceae tested: | | EA Tot | EA N | EA % | Eval EA Tot | Eval EA N | Eval EA % | CA N | CA % | #R | min | maj | vmj | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Clinical | 988 | 960 | 97.7 | 702 | 686 | 97.7 | 870 | 88.1 | 428 | 112 | 5 | 1 | | Challenge | 64 | 64 | 100 | 33 | 33 | 100 | 59 | 92.2 | 36 | 5 | 0 | 0 | | Total | 1052 | 1024 | 97.3 | 735 | 719 | 97.8 | 929 | 88.3 | 464 | 117 | 5 | 1 | EA-Essential Agreement CA-Category Agreement R-resistant isolates maj-major discrepancies vmj-very major discrepancies min- minor discrepancies The maj, vmj, EA and EA of evaluable are acceptable. The CA is low due to mostly minor errors. Of the 117 minor errors, 97 are within EA but not CA. {6} Given the high EA, the lower than expected CA are mainly due to minor errors which is acceptable. 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: The interpretative criteria and the recommended Quality Control Ranges are the same as the FDA and CLSI. Enterobacteriaceae; ≤ 8/4 (S), 16/8 (I), ≥ 32/16 (R) N. Proposed Labeling: The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10. O. Conclusion: The submitted information in this premarket notification is complete and supports a substantial equivalence decision. 7
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...