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The MIC value definition faithfully reflects antimicrobial sensitivity, profoundly impacting the infection's clinical outcome. Our study aimed to evaluate the Accelerate PhenoTM System in defining the importance of fast phenotypic susceptibility data. A number of 270 monomicrobial samples simultaneously underwent standard procedures and fast protocols after a contemporary Gram stain. Finally, we provided Turn-around Time (TAT) and statistical evaluations. The fast technology required a medium value of 7 h to complete ID and AST profiles. Although there were some spectrum limitations, it revealed an optimal success rate in microbial identification directly from positive blood cultures. The Gram-negative AST reached a 98.9% agreement between the Accelerate Pheno™ System and the standard method. In addition, the Gram-positive AST gathered a 98.7% agreement comparing the same systems. The chance to rapidly provide precise MIC values is one of the last frontiers in clinical microbiology, especially in high-prevalence antimicrobial resistance areas. [ABSTRACT FROM AUTHOR]

• The importance to rapidly provide a microbiological diagnosis in the case of severe infections. • The volatile organic compounds (VOCs) detection may be used to investigate bacterial susceptibility profiles. • A real-life laboratory experience demonstrated a 100 % essential agreement between VOCs detection though the VITEKⓇ REVEAL™ technology and the conventional turbidimetric methods. • The study results encourage the application of the method in high-risk epidemiological areas, confirming the effectiveness of VOC detection in monitoring multi-drug-resistant bacteria susceptibility profiles. Systemic bacterial infections represent a significant clinical challenge due to the increasing resistance rate towards antimicrobials. An essential key to controlling antimicrobial resistance spread is to administer targeted therapy after a precise minimum inhibitory concentration reporting. Among the available fast technologies for antimicrobial susceptibility testing (AST), the VITEKⓇ REVEAL™ (Biomerieux, Florence, Italy) proposes volatile organic compounds (VOC) colourimetric arrays to discriminate between susceptible and resistant Gram-negative isolates directly from positive blood cultures. We evaluated this methodology during a four-month laboratory experience on 40 positive blood culture samples, reporting a comparison to standard culture-based methods. The protocol revealed an essential agreement of 100 % between the conventional and the experimental procedures, while the categorical agreement resulted in 97.5 % due to one very major error (VME) for meropenem/vaborbactam in K. pneumoniae. Although further studies will be necessary to investigate its performance on rare microorganisms, the VITEKⓇ REVEAL™ demonstrated an optimal sensitivity in defining MIC values for multi-drug resistant (MDR) microorganisms. These results encourage the application of the method in all high-risk epidemiological areas, confirming the effectiveness of VOC detection in monitoring bacterial susceptibility profiles. [ABSTRACT FROM AUTHOR]