Most antimicrobial lists found in VITEK® 2 software – such as those found in the “AES Detail” or “AST Configuration” screens – are sorted alphabetically by default and this cannot be changed. However, the “Isolate Detail” screen is different. Its default display setting is by antimicrobial family, with the order within each family further sorted based on the efficacy of the antimicrobial.
Here is an example of an “Isolate Detail” screen with the default sort order (Figure 1):
You can easily customize this antimicrobial order on the “Isolate Detail” screen using a computer directly linked to the instrument. Lab reports and chart reports generated from the “Isolate Detail” screen will follow the same custom order, but other list views, such as the “AES Detail” will remain unchanged. There are many reasons to implement a custom sorting to better suit the needs of your institution. For example you may wish to:
- List antimicrobials in alphabetical order
- Separate unrestricted and restricted antimicrobials according to your institution’s formulary so that, for example, unrestricted drugs are grouped and listed before other drugs
- Align the listing to match the order found in your LIS
- Or many other possible configurations that are meaningful for your institution.
If you want to customize your “Isolate Detail” screen, here’s how:
- Log in Log into your VITEK® 2 Systems Software with supervisor privileges, and navigate to AST Configuration. (See Figure 2)
- Click Sort Click the Antibiotic Sort Order tab.
- Lock/Unlock Click the Lock/Unlock button and click “Yes” on the dialog pop-up box that is displayed to make changes within the configuration.
- Select AST card Use the Card Type drop down menu to select the AST card for which you’d like to customize the antimicrobial order.
As shown in Figure 3 below, the first thing you will notice is that there are two columns: “Antibiotics” and “Sorted Antibiotics”. The “Antibiotics” column on the left shows all drugs on the card that have not yet been added to the “Sorted Antibiotics” column on the right. In the left column, the antibiotics are always displayed in alphabetical order with the exception of deduced drugs. These appear at the bottom of the list in alphabetical order with a “plus sign” in front of the antibiotic name. (In this example we can see that “+ Amoxicillin/Clavulanic Acid”, “+ Amoxicillin/Sulbactam” and “+ Ceftriaxone” are deduced.) Note: You can add deduced drugs to this list by configuring them in VITEK® 2 software. If you would like to include deduced drugs on these lists you will want to consider configuring the software to allow them to be displayed prior to editing antimicrobial sort order. A future Tips & Tricks article will discuss what deduced antimicrobials are, as well as how to configure the software to allow deduced results to be displayed in “Isolate Detail” view, lab reports and chart reports.
In the example in Figure 3, we can tell that sort order has never been configured for the AST-GP67 card, since the “Sorted Antibiotics” column shown on the right doesn’t list any antimicrobials. If someone in your lab had previously configured sort order, you would see the antimicrobials listed there.
- Move to Sorted column Now it’s time to move antimicrobials from the left to the sorted right column. Select them with a mouse-click and then click the icon circled below in red (Figure 4). Multiple antibiotics can be selected and moved simultaneously as shown in Figure 4. To do so, just select the first drug in the list and then hold the shift-key down while clicking the last drug on the list with the mouse. Alternatively, you can selectively choose drugs by holding the control-key down while clicking the ones you want with the mouse.
NOTE – The following is extremely important: All antimicrobials displayed in the left “Antibiotics” column MUST be moved to the right “Sorted Antibiotics” column in order to define your custom sort order. VITEK® 2 software will not accept a customized sort order if antimicrobials remain in the left “Antibiotics” column, and the following warning (Figure 5) will be displayed if one tries to save such a configuration.
- Change sort order Once the antimicrobials have been moved to the “Sorted Antibiotics” column, they will now appear in the same order on the “Isolate Detail” screen and accompanying reports, as seen in Figure 4. You can lock and save the configuration with no further modifications if you want. But let’s say that you want to modify the list so that Cefoxitin Screen results appear first on the list. You can select Cefoxitin Screen and move it up or down one position by clicking the “Move Up” or “Move Down” icon circled in red in the upper right-hand side of the screen shown in Figure 6. In this way, you can easily change the order in which antimicrobials are displayed in your “Isolate Detail” list.
But wait!! What if you don’t want all antimicrobials in your customized sort order to be reported? Don’t worry… bioART rules can be written to suppress analysis of antimicrobials, or alternatively, antimicrobials can be suppressed from reporting. No results are generated if antimicrobials are suppressed from analysis, whereas antimicrobials suppressed from reporting will appear on the laboratory report but not appear on chart reports.
Now what are you waiting for? It’s time to organize antimicrobials in a way that makes the most sense for your ID/AST reporting… just use your new Tips & Tricks skills.