Performing antimicrobial susceptibility testing and related systems and methods

1. A method for performing multi-assay rapid antimicrobial susceptibility testing sequences, the method comprising:

inoculating a sample comprising a microorganism derived from a clinical sample into (i) a plurality of antimicrobial wells of a test panel containing one or more antimicrobials of a plurality of antimicrobials for inoculation of the sample and (ii) a plurality of control wells of said test panel;

loading the test panel into an automated rapid antimicrobial susceptibility testing system for performing a multi-assay testing sequence, wherein the antimicrobial wells and control wells are each arranged in one or both of rows and columns within the test panel, and the test panel lies in a horizontal plane within the antimicrobial susceptibility testing system; and

operating the testing system to:

move the loaded test panel to an incubation assembly comprising a nest assembly adapted to: i) house at least one test panel, ii) allow a fluid processing system access to deliver and withdraw fluid to the antimicrobial and control wells of each test panel, and iii) facilitate incubation of one or more test panels in order to undergo the multi-assay testing sequence;

incubate the inoculated sample in the incubation assembly;

periodically measure an amount of sample growth in a plurality of control wells by a checkpoint assay;

responsive to determining that a level of growth in the control wells meets or exceeds a threshold level of growth, stop incubation;

perform one or more end point assays on incubated samples in the plurality of antimicrobial wells of the test panel, wherein at least one of the one or more end point assays comprise a different type of interrogation than the checkpoint assay;

move the loaded test panel to a centrifugation subsystem configured to receive a plurality of loaded test panels;

centrifuge the loaded test panel;

measure an optical output from the sample in the plurality of antimicrobial wells of the test panel, the optical output corresponding to an amount of the microorganism remaining in each of the plurality of antimicrobial wells; and

report at least one of: a minimum inhibitory concentration of and/or a qualitative susceptibility interpretation for the microorganism remaining in each of the plurality of antimicrobial wells and the plurality of antimicrobials.

2. The method of claim 1 wherein the performing the end point assay comprises one or more of: liquid handling, centrifugation, incubation, or shaking of the sample.

3. The method of claim 2 wherein the liquid handling comprises performing one or more aspiration and/or liquid addition steps.

4. The method of claim 3 wherein the performing the end point assay comprises a plurality of binding steps.

5. The method of claim 4 wherein an amplification species of the binding steps comprises at least one of: europium, terbium, samarium, or dysprosium.

6. The method of claim 1 wherein the testing system is configured to process simultaneously at least 2, at least 4, at least 6, at least 8, at least 10, or at least 12 test panels.

7. The method of claim 1 wherein the testing system is configured to yield a testing sequence throughput of at least 2, at least 4, at least 6, at least 8, at least 10, at least 12, or at least 16, at least 20 test panels per hour.

8. The method of claim 1 wherein a time duration for processing a test panel through the testing sequence from insertion of the test panel into the testing system to obtaining a result is less than 8 hours, less than 6 hours, less than 5 hours, less than 4 hours, less than 3 hours, or less than 2 hours.

9. The method of claim 1 wherein the test panel comprises a cartridge.

10. A method for performing multi-assay rapid antimicrobial susceptibility testing sequences, the method comprising:

inoculating a sample comprising a microorganism derived from a clinical sample into a plurality of wells of a test panel, at least a portion of the plurality of wells containing one or more antimicrobials of a plurality of antimicrobials for inoculation of the sample and (ii) a plurality of control wells of said test panel;

loading the test panel into an automated rapid antimicrobial susceptibility testing system for performing a multi-assay testing sequence, wherein the wells and control wells are each arranged in one or both of rows and columns within the test panel, and the test panel lies in a horizontal plane within the antimicrobial susceptibility testing system; and

operating the testing system to:

move the loaded test panel to an incubation assembly comprising a nest assembly adapted to: i) house at least one test panel, ii) allow a fluid processing system access to deliver and withdraw fluid to the wells of each test panel, and iii) facilitate incubation of one or more test panels in order to undergo the multi-assay testing sequence;

incubate the inoculated sample in the incubation assembly;

periodically measure an amount of sample growth in a plurality of control wells of the plurality of wells by a checkpoint assay;

responsive to determining that a level of growth in the control wells meets or exceeds a threshold level of growth, stop incubation;

perform one or more end point assays on incubated samples in the test panel and in a second plurality of control wells, wherein the checkpoint assay and the one or more end point assays are performed on different wells of the test panel, and wherein at least one of the one or more end point assays comprise a different type of interrogation than the checkpoint assay;

move the loaded test panel to a centrifugation subsystem configured to receive a plurality of loaded test panels;

centrifuge the loaded test panel;

measure an optical output from the sample in the plurality of wells of the test panel, the optical output corresponding to an amount of the microorganism remaining in each of the plurality of wells; and

report at least one of: a minimum inhibitory concentration of and/or a qualitative susceptibility interpretation for the microorganism remaining in each of the plurality of wells and the plurality of antimicrobials.

11. A method for performing multi-assay rapid antimicrobial susceptibility testing sequences, the method comprising:

inoculating a sample comprising a microorganism derived from a clinical sample into a plurality of wells of a test panel, at least a portion of the plurality of wells containing one or more antimicrobials of a plurality of antimicrobials for inoculation of the sample and (ii) a plurality of control wells of said test panel;

loading the test panel into an automated rapid antimicrobial susceptibility testing system for performing a multi-assay testing sequence, wherein the antimicrobial wells and control wells are each arranged in one or both of rows and columns within the test panel, and the test panel lies in a horizontal plane within the antimicrobial susceptibility testing system; and

operating the testing system to:

move the loaded test panel to an incubation assembly comprising a nest assembly adapted to: i) house at least one test panel, ii) allow a fluid processing system access to deliver and withdraw fluid to the wells of each test panel, and iii) facilitate incubation of one or more test panels in order to undergo the multi-assay testing sequence;

incubate the inoculated sample in the incubation assembly;

periodically measure an amount of sample growth in a first subset of the plurality of wells by a checkpoint assay;

responsive to determining that a level of growth in said first subset of the plurality of wells meets or exceeds a threshold level of growth, stop incubation;

perform one or more end point assays on incubated samples in a second subset of the plurality of wells and control wells, wherein at least one of the one or more end point assays comprise a different type of interrogation than the checkpoint assay;

move the loaded test panel to a centrifugation subsystem configured to receive a plurality of loaded test panels;

centrifuge the loaded test panel;

measure an optical output from the second subset of the plurality of wells, the optical output corresponding to an amount of the microorganism remaining in each of the plurality of wells; and

report at least one of: a minimum inhibitory concentration of and/or a qualitative susceptibility interpretation for the microorganism remaining in each of the plurality of wells and the plurality of antimicrobials.

12. The method of claim 11 wherein the performing the end point assay comprises one or more of: liquid handling, centrifugation, incubation, or shaking of the sample.

13. The method of claim 12 wherein the liquid handling comprises performing one or more aspiration and/or liquid addition steps.

14. The method of claim 13 wherein the performing the end point assay comprises a plurality of binding steps.

15. The method of claim 14 wherein an amplification species of the binding steps comprises at least one of: europium, terbium, samarium, or dysprosium.

16. The method of claim 11 wherein the testing system is configured to process simultaneously at least 2, at least 4, at least 6, at least 8, at least 10, or at least 12 test panels.

17. The method of claim 11 wherein the testing system is configured to yield a testing sequence throughput of at least 2, at least 4, at least 6, at least 8, at least 10, at least 12, or at least 16, at least 20 test panels per hour.

18. The method of claim 11 wherein a time duration for processing a test panel through the testing sequence from insertion of the test panel into the testing system to obtaining a result is less than 8 hours, less than 6 hours, less than 5 hours, less than 4 hours, less than 3 hours, or less than 2 hours.