(222 days)
No reference Devices were used in this submission.
No
The description focuses on automation of manual laboratory steps using a vision system for operator-designated colony picking and a pipetting system. There is no mention of AI/ML algorithms for image analysis, colony selection, or any other function. The "Colibrí Vision System" is used for the operator to designate colonies on a digital plate, not for automated AI/ML-driven analysis.
No.
The device is an in vitro diagnostic device used in clinical laboratories to identify bacterial infections and test antimicrobial susceptibility. It does not directly treat or prevent a disease or condition in a patient, which is the definition of a therapeutic device.
Yes
The "Intended Use / Indications for Use" section explicitly states, "The Collbri™ System is an in vitro diagnostic device." It also mentions its use "to aid in the diagnosis of bacterial infections."
No
The device description explicitly states that the Colibrí System comprises "Colibrí Vision System and Colibrí Preparation Station hardware modules and pipette tips, Primary Tubes, Spreader and nephelometer Verification Kit as consumables." This indicates the device includes significant hardware components beyond just software.
Yes, the Collbri™ System is an In Vitro Diagnostic (IVD) device.
Here's why, based on the provided text:
- Intended Use/Indications for Use: The document explicitly states, "The Collbri™ System is an in vitro diagnostic device..." It also describes its use "to aid in the diagnosis of bacterial infections" by preparing samples for identification and susceptibility testing.
- Device Description: The description details how the system is used as an accessory to other IVD systems (MALDI-TOF MS and VITEK 2 AST systems) to automate pre-analytical steps for bacterial identification and AST. These downstream systems are themselves IVDs used in clinical laboratories for diagnostic purposes.
- Clinical Laboratory Use: The device is intended for use by "trained healthcare professionals in clinical laboratories." This is a common setting for IVD devices.
- Performance Studies: The document includes summaries of analytical studies and an AST challenge test, which are typical performance evaluations for IVD devices to demonstrate their accuracy and reliability in a clinical context.
While the Collbri™ System is a pre-analytical processor, its function is directly tied to preparing samples for downstream diagnostic tests (bacterial identification and AST) that are used to aid in the diagnosis of bacterial infections. Therefore, it falls under the definition of an IVD device.
N/A
Intended Use / Indications for Use
The Collbri™ System is an in vitro diagnostic device comprised of the Collbri™ Preparation Station for use with the bioMérieux VITEK® MS or Bruker MALDI Biotyper® CA mass spectrometry systems for qualitative identification and with the bioMérieux VITEK® 2 Antimicrobial Susceptibility Testing (AST) system for qualitative testing of isolated colonies of gram-negative and gram-positive bacterial species grown on solid culture media. The Collbri™ System is a semi-automated pre-analytical processor that picks isolated colonies designated by the operator and uses a pipetting system to prepare MALDI-TOF MS (Matrix-Assisted Laser Desorption/Jonization-Time of Flight Mass Spectrometry) target slides for bacterial identification and microbial suspension at known concentration for Antimicrobial Susceptibility Testing and purity assessment.
The Colibri™ software records the identity of each sample and its position on the target slide and communicates this information electronically to the MALDI-TOF MS analyzers.
Bacterial suspensions for AST and purity plates are identified by barcode label.
The Colibr™ System is intended for use by trained healthcare professionals in clinical laboratories in conjunction with other clinical and laboratory finding Gram staining, to aid in the diagnosis of bacterial infections.
The Collbri™ System has not been validated for use in the identification or processing of yeast species, Mocardia, or mycobacteria.
Product codes (comma separated list FDA assigned to the subject device)
LON, QQV, QBN
Device Description
The Copan Colibrí System is designed to be used as an accessory of the downstream MALDI-TOF MS and antimicrobial susceptibility testing (AST) analyzers automating various manual steps in the workflow for the preparation of samples for the identification of isolated colonies and for AST of isolated colonies of gram-negative and gram-positive bacterial species grown on solid culture media.
The Colibrí System automates the preparation of MALDI target slides for the bioMérieux VITEK MS or the Bruker MALDI Biotyper CA System that are used in clinical laboratories for identification (ID) of organisms grown on plated media by Matrix-Assisted Laser Desorption/Jonization Time-of Flight Mass Spectrometry (MALDI-TOF MS). The Colibri System automates the preparation of microbial suspensions at known concentration for bioMérieux VITEK 2 System that is used in clinical laboratories for AST analyses. Moreover, the Colibri System is used for Purity Plates preparation for purity assessments.
The Colibrí System comprises the Colibrí Vision System and Colibrí Preparation Station hardware modules and pipette tips, Primary Tubes, Spreader and nephelometer Verification Kit as consumables. After appropriate plate incubation, the operator using the graphical User Interface (Image Reading Interface) chooses the plates exhibiting adequate growth and selects the isolated colonies to be processed assigning the automatic ID or AST tasks. By using the Colibrí Vision System, specific colonies to be picked are designated by the operator on a digital plate. The Operator manually loads the plates in the Colibri Preparation Station where colonies are automatically picked, spotted on the target slide and overlayed with the matrix or suspended into the dedicated solution for the preparation of the microbial suspension for AST purposes (Secondary Tube).
When used in conjunction with the bioMérieux VITEK MS, the Colibrí System can prepare the 48-spot target slides by performing the direct spotting of colonies. The calibrator used for quality control is manually applied by the operator at the end of the automated colony spotting. When used in conjunction with the Bruker MALDI Biotyper CA System, the Colibrí System can prepare either reusable 48-spot or disposable 96-spot targets by performing the Direct Transfer Sample Procedure. The BTS used for quality control is manually applied by the operator at the automated colony spotting.
When used in conjunction with the bioMérieux VITEK 2, the Colibrí System can prepare the microbial suspension at the proper concentration by direct colony suspension method. The onboard nephelometer allows the preparation of Secondary Tubes (AST suspensions) at the correct concentration and the Colibrí Spreader is used for Purity Plates preparation.
The Colibrí software records the identity of each sample and its position on the target slide and communicates this information electronically to the MALDI-TOF MS analyzers.
The traceability of prepared Secondary Tube and Purity Plates is maintained by dedicated labels applications.
Colibri System requires four different calibrations, one on the nephelometer, three on the cameras. None of these calibration activities require user intervention if not in terms of periodical cleaning of the mechanical component as described in the dedicated section of the User Manual. The Set-up calibration of nephelometer and camera units positioned on the Colibrí Vision System and on the Colibrí Preparation Station are performed during the device initial setup. Auto-calibration is performed at the end of the initial set-up and periodically during the preventive maintenance to check that, in the Collbrí Preparation all the mechanical references can be found inside the positioning tolerances, that the I/Os are responsive. Run-time calibration is performed during the normal usage to automatically check the proper functioning of the Colibrí Vision System and the Colibrí Preparation Station.
Colibrí System requires a daily nephelometer verification to check the proper reading of suspensions at different turbidity values.
Mentions image processing
Yes, "By using the Colibrí Vision System, specific colonies to be picked are designated by the operator on a digital plate." and "The colony to be picked is selected by an operator on a digital plate using the Graphical User Interface of a Vision System."
Mentions AI, DNN, or ML
Not Found
Input Imaging Modality
Not Found
Anatomical Site
Not Found
Indicated Patient Age Range
Not Found
Intended User / Care Setting
trained healthcare professionals in clinical laboratories
Description of the training set, sample size, data source, and annotation protocol
Not Found
Description of the test set, sample size, data source, and annotation protocol
Not Found
Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)
Analytical Studies:
- Nephelometer Calibration Verification:
- Study Type: Verification of onboard nephelometer accuracy.
- Sample Size: 300 suspensions (20 suspensions per concentration, 3 operators, 3 Colibrí Systems).
- Key Results: 100% of suspensions contained the correct concentration of bacteria based on viable cell count, demonstrating acceptable accuracy.
- Pipettor Trueness and Precision:
- Study Type: Gravimetric determination of pipettor accuracy and reproducibility.
- Sample Size: 10 measurements for four volumes (50uL, 100uL, 500uL, 900uL) on 3 Colibrí System pipettors.
- Key Results: Trueness and reproducibility were within acceptance criteria for all volumes.
- E. coli Suspensions Preparation Verification Study:
- Study Type: Assessment of ability to prepare and manage Primary Tubes at various concentrations.
- Sample Size: E. coli ATCC® 25922 colonies processed on 3 Colibrí Systems by 3 operators.
- Key Results: 100% of Primary Tubes were correctly managed, and suspensions contained the expected number of colonies.
- Validation of Colony Picking and Preparation of Microbial Suspensions for AST:
- Study Type: Accuracy of colony picking and microbial suspension preparation via purity check and bacterial concentration determination.
- Sample Size: Isolated colonies of 6 bacterial species (3 Gram-Negative, 3 Gram-Positive) in 2 polymicrobial mixtures on various media types and incubation times, processed on 3 Colibrí Systems.
- Key Results: 100% of designated colonies were correctly picked, 100% of Purity Plates showed no contamination, indicating accurate picking and no cross-contamination. 99.2% of prepared suspensions had microbial concentration within acceptable limits, and >98% for each instrument.
AST Challenge Test:
- Study Type: Evaluation of accuracy of MICs obtained by bioMérieux VITEK 2 using Colibrí System for microbial suspensions preparation compared to manual preparation.
- Sample Size: Representative isolates of Enterobacterales (n=62), Staphylococcus (n=16), Streptococcus (n=30), Enterococcus (n=16), and non-fermenters (n=32), including susceptible and resistant strains, tested on 3 Colibrí Systems.
- Key Results:
- Overall Essential Agreement (EA) of evaluable MIC results was > 99.9%.
- Overall Category Agreement (CA) was 99.3%.
- 1882/1883 evaluable MIC results were within one doubling dilution of the comparator method.
- 5947/5991 SIR categorizations were in agreement.
Reproducibility Study:
- Study Type: Consistency of AST results from bioMérieux VITEK 2 on microbial suspensions prepared by different Colibrí Systems and operators over multiple days.
- Sample Size: Culture media with isolated colonies of various Gram-Positive and Gram-Negative strains, processed on 3 Colibrí Systems by 3 operators over 3 days. Each condition tested in triplicate for 81 replicates per combination.
- Key Results: MIC results were reproducible between instruments, operators, and days, with high percentage agreement (e.g., Ampicillin/Sulbactam 100% combined best and worst case; Piperacillin/Tazobactam 99.3% best, 98.3% worst combined; Cefoxitin 99.6% best, 97.9% worst combined).
Purity Plate Growth: - Study Type: Verification of monomicrobial suspensions and prevention of cross-contamination based on purity plates.
- Sample Size: 2,364 purity plates prepared by different Colibrí™ Preparation Stations throughout analytical studies.
- Key Results: 100% of purity plates (2364/2364) were correctly processed and provided evidence of monomicrobial suspensions and no cross-contamination.
Sample preparation for Quality Control: - Study Type: Demonstration of reproducibility of MIC results for AST Quality Control organisms using Colibrí System as suspension preparator.
- Sample Size: Not explicitly stated but conducted daily on each instrument involved in Analytical Studies with appropriate AST panels.
- Key Results: 100% of MIC values for each drug/organism combination were within the established ranges reported in the AST analyzer labeling. Purity of all suspensions confirmed.
Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)
See table on page 11, 14.
AST Challenge Study:
- Essential Agreement (%EA) for various agents and organism groups, ranging from 99.0% to 100%. Highlighted overall >99.9% EA.
- Category Agreement (%CA) for various agents and organism groups, ranging from 95.8% to 100%. Highlighted overall 99.3% CA.
- Very Major Category Error (#vmj): 0 errors reported across all agents and organism groups.
- Major Category Error (#maj): 0 or 1 errors reported across all agents and organism groups.
- Minor Category Error (#min): Values ranging from 0 to 5 errors reported across various agents and organism groups.
Reproducibility Study:
- Best caseª (%) and Worst caseᵇ (%) for different antibiotics and instrument combinations, with most values being 98% or higher, many at 100%.
Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.
Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.
No reference Devices were used in this submission.
Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).
Not Found
§ 866.1645 Fully automated short-term incubation cycle antimicrobial susceptibility system.
(a)
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.(b)
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.”
0
Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo features the letters 'FDA' in a blue square, followed by the words 'U.S. FOOD & DRUG ADMINISTRATION' in blue text.
October 5, 2022
Copan WASP S.r.l. Chiara Congiu Regulatory Affairs Via A. Grandi, 32 Brescia, Brescia 25125 Italy
Re: K220546
Trade/Device Name: Colibrí System Regulation Number: 21 CFR 866.1645 Regulation Name: Fully Automated Short-Term Incubation Cycle Antimicrobial Susceptibility System Regulatory Class: Class II Product Code: LON, QQV, QBN Dated: February 18, 2022 Received: February 25, 2022
Dear Chiara Congiu:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part
1
801 and Part 809); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
For: Uwe Scherf, Ph.D. Director Division of Microbiology Devices OHT7: Office of In Vitro Diagnostics Office of Product Evaluation and Ouality Center for Devices and Radiological Health
Enclosure
2
Indications for Use
510(k) Number (if known) K220546
Device Name Colibrí System
Indications for Use (Describe)
The Collbri™ System is an in vitro diagnostic device comprised of the Collbri™ Preparation Station for use with the bioMérieux VITEK® MS or Bruker MALDI Biotyper® CA mass spectrometry systems for qualitative identification and with the bioMérieux VITEK® 2 Antimicrobial Susceptibility Testing (AST) system for qualitative testing of isolated colonies of gram-negative and gram-positive bacterial species grown on solid culture media. The Collbri™ System is a semi-automated pre-analytical processor that picks isolated colonies designated by the operator and uses a pipetting system to prepare MALDI-TOF MS (Matrix-Assisted Laser Desorption/Jonization-Time of Flight Mass Spectrometry) target slides for bacterial identification and microbial suspension at known concentration for Antimicrobial Susceptibility Testing and purity assessment.
The Colibri™ software records the identity of each sample and its position on the target slide and communicates this information electronically to the MALDI-TOF MS analyzers.
Bacterial suspensions for AST and purity plates are identified by barcode label.
The Colibr™ System is intended for use by trained healthcare professionals in clinical laboratories in conjunction with other clinical and laboratory finding Gram staining, to aid in the diagnosis of bacterial infections.
The Collbri™ System has not been validated for use in the identification or processing of yeast species, Mocardia, or mycobacteria.
Type of Use (Select one or both, as applicable) |
---|
☑ Prescription Use (Part 21 CFR 801 Subpart D) |
☐ Over-The-Counter Use (21 CFR 801 Subpart C) |
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3
I. Submitter
| Applicant Name: | Copan WASP Srl
Via A. Grandi 32
25125 Brescia, Italy
+39 030 2687211
copan.regulatory@copangroup.com |
|------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|
| Contact Person | Chiara Congiu
Copan WASP Srl
Via A. Grandi 32
25125 Brescia, Italy
+39 338 6904942
copan.regulatory@copangroup.com |
| Establishment Registration Number: | 3009288740 |
| Date Prepared: | February 18, 2022 |
II. Device Name
Proprietary Name | Colibrí System |
---|---|
Common/Usual Name | Colibrí System |
Classification Name | Fully automated short-term incubation cycle antimicrobial susceptibility system (21 CFR 866. 1645) |
Clinical mass spectrometry microorganism identification and differentiation system (21 CFR 866.3378) [Cleared, K193138] | |
Device Class | II |
Product Code | LON |
Panel | QQV, QBN [Cleared, K193138] |
Microbiology |
4
III. Legally Marketed Predicate Device
| Device Name | VITEK 2 Gram Negative Imipenem & VITEK 2
Systems (PC) 5.02 Software |
|---------------|------------------------------------------------------------------------|
| 510(K) Number | K103752 |
No reference Devices were used in this submission.
IV. Device Description
The Copan Colibrí System is designed to be used as an accessory of the downstream MALDI-TOF MS and antimicrobial susceptibility testing (AST) analyzers automating various manual steps in the workflow for the preparation of samples for the identification of isolated colonies and for AST of isolated colonies of gram-negative and gram-positive bacterial species grown on solid culture media.
The Colibrí System automates the preparation of MALDI target slides for the bioMérieux VITEK MS or the Bruker MALDI Biotyper CA System that are used in clinical laboratories for identification (ID) of organisms grown on plated media by Matrix-Assisted Laser Desorption/Jonization Time-of Flight Mass Spectrometry (MALDI-TOF MS). The Colibri System automates the preparation of microbial suspensions at known concentration for bioMérieux VITEK 2 System that is used in clinical laboratories for AST analyses. Moreover, the Colibri System is used for Purity Plates preparation for purity assessments.
The Colibrí System comprises the Colibrí Vision System and Colibrí Preparation Station hardware modules and pipette tips, Primary Tubes, Spreader and nephelometer Verification Kit as consumables. After appropriate plate incubation, the operator using the graphical User Interface (Image Reading Interface) chooses the plates exhibiting adequate growth and selects the isolated colonies to be processed assigning the automatic ID or AST tasks. By using the Colibrí Vision System, specific colonies to be picked are designated by the operator on a digital plate. The Operator manually loads the plates in the Colibri Preparation Station where colonies are automatically picked, spotted on the target slide and overlayed with the matrix or suspended into the dedicated solution for the preparation of the microbial suspension for AST purposes (Secondary Tube).
When used in conjunction with the bioMérieux VITEK MS, the Colibrí System can prepare the 48spot target slides by performing the direct spotting of colonies. The calibrator used for quality control is manually applied by the operator at the end of the automated colony spotting. When used in conjunction with the Bruker MALDI Biotyper CA System, the Colibrí System can prepare either reusable 48-spot or disposable 96-spot targets by performing the Direct Transfer Sample Procedure. The BTS used for quality control is manually applied by the operator at the automated colony spotting.
When used in conjunction with the bioMérieux VITEK 2, the Colibrí System can prepare the microbial suspension at the proper concentration by direct colony suspension method. The onboard nephelometer allows the preparation of Secondary Tubes (AST suspensions) at the correct concentration and the Colibrí Spreader is used for Purity Plates preparation.
Copan WASP S.r.l., Traditional 510(k)- Colibrí System
5
The Colibrí software records the identity of each sample and its position on the target slide and communicates this information electronically to the MALDI-TOF MS analyzers.
The traceability of prepared Secondary Tube and Purity Plates is maintained by dedicated labels applications.
Colibri System requires four different calibrations, one on the nephelometer, three on the cameras. None of these calibration activities require user intervention if not in terms of periodical cleaning of the mechanical component as described in the dedicated section of the User Manual. The Set-up calibration of nephelometer and camera units positioned on the Colibrí Vision System and on the Colibrí Preparation Station are performed during the device initial setup. Auto-calibration is performed at the end of the initial set-up and periodically during the preventive maintenance to check that, in the Collbrí Preparation all the mechanical references can be found inside the positioning tolerances, that the I/Os are responsive. Run-time calibration is performed during the normal usage to automatically check the proper functioning of the Colibrí Vision System and the Colibrí Preparation Station.
Colibrí System requires a daily nephelometer verification to check the proper reading of suspensions at different turbidity values.
V. Intended Use / Indications For Use
The Colibrí System is an in vitro diagnostic device comprised of the Colibrí Vision System and Colibrí Preparation Station for use with the bioMérieux VITEK MS or Bruker MALDI Biotyper CA mass spectrometry systems for qualitative identification and with the bioMérieux VITEK 2 Antimicrobial Susceptibility Testing (AST) system for qualitative testing of isolated colonies of gram-negative and gram-positive bacterial species grown on solid culture media. The Colibrí System is a semi-automated pre-analytical processor that picks isolated colonies designated by the a pipetting system to prepare operator and uses MALDI-TOF MS (Matrix-Laser Desorption/Ionization- Time Of Flight Mass Spectrometry) target slides for Assisted bacterial identification and microbial suspension at known concentration for Antimicrobial Susceptibility Testing and purity assessment.
The Colibrí software records the identity of each sample and its position on the target slide and communicates this information electronically to the MALDI-TOF MS analyzer.
Bacterial suspensions for AST and Purity Plates are identified by barcode label.
The Colibrí System is intended for use by trained healthcare professionals in clinical laboratories in conjunction with other clinical and laboratory findings, including Gram staining, to aid in the diagnosis of bacterial infections.
The Colibrí System has not been validated for use in the identification or processing of yeast species, molds, Nocardia, or mycobacteria.
6
VI. Comparison to Predicate
Colibrí System is designed to automatize the standard manual workflow for the preparation of microbial suspension for AST via direct colony suspension method and purity assessment decreasing the risk of cross-contamination among colonies grown on the culture plate, the risk of scratching from the media plate surface and the risk to use AST suspensions at improper concentration. Specifically, the Colibrí Vision System aids the operator in selecting single, well-isolated colonies. The Colibrí Preparation Station allows the automatic picking of the preselected colonies and their suspension into the saline solution of the Primary Tube. The Primary Tube turbidity is checked by the on-board nephelometer to assure it is in the proper working range, allowing the preparation of a Secondary Tube at a precise concentration. The Colibri Preparation Station labels the Secondary Tube and the Purity Plate, optionally prepared, for traceability.
With reference to the sample preparation workflow for AST testing, comparison with the Predicate Device is provided in the following tables:
Similarities | ||
---|---|---|
Item | New Device | Predicate Device |
Device Name | ||
(K number) | Colibrí System | |
(K220546) | VITEK 2 Gram Negative Imipenem & | |
VITEK 2 Systems (PC) 5.02 Software | ||
(K103752) | ||
Device Classification | Class II (special controls) | Class II (special controls) |
Regulation Number | 21 CFR 866.1645 Fully automated short-term incubation cycle antimicrobial susceptibility system | 21 CFR 866.1645 Fully automated short-term incubation cycle antimicrobial susceptibility system |
Product Code | LON System, Test, Automated, Antimicrobial Susceptibility, Short Incubation | LON System, Test, Automated, Antimicrobial Susceptibility, Short Incubation |
Indications for Use | The Colibrí System is an in vitro diagnostic device comprised of the Colibrí Vision System and Colibrí Preparation Station for use with the bioMérieux VITEK MS or Bruker MALDI Biotyper CA mass spectrometry systems for qualitative identification and with the bioMérieux VITEK 2 Antimicrobial Susceptibility Testing (AST) system for qualitative testing of isolated colonies of Gram-Negative and Gram-Positive bacterial species grown on solid culture media. The Colibrí System is a semi-automated pre-analytical processor that picks isolated colonies designated by the operator and uses a pipetting system to prepare MALDI-TOF MS (Matrix-Assisted Laser Desorption/Ionization-Time Of Flight Mass Spectrometry) target slides and microbial suspension at known concentration for Antimicrobial Susceptibility Testing and purity assessment. | |
The Colibrí software records the identity of each sample and its position on the target slide and communicates this information electronically to the MALDI-TOF MS analyzer. | ||
Bacterial suspensions for AST and Purity Plates are identified by barcode label. | ||
The Colibrí System is intended for use by trained healthcare professionals in clinical laboratories in conjunction with other clinical and laboratory findings, including Gram staining, to aid in the | VITEK 2 GN Imipenem is designed for antimicrobial susceptibility testing of Gram-Negative bacilli. VITEK 2 GN Imipenem is a quantitative test intended for use with the VITEK 2 and VITEK 2 Compact Systems using VITEK 2 Systems 5.02 Software as a laboratory aid in the determination of in vitro susceptibility to antimicrobial agents. Imipenem has been shown to be active both in vitro and in clinical infections against most strains of the following microorganisms according to the FDA label for the antimicrobial. | |
Active in vitro and in clinical infections: | ||
Acinetobacter spp. | ||
Citrobacter spp. | ||
Enterobacter aerogenes | ||
Escherichia coli | ||
Klebsiella spp. | ||
Active in vitro but clinical significance unknown: | ||
Providencia stuartii | ||
The VITEK 2 Antimicrobial Susceptibility Test (AST) is intended to be used with the VITEK 2 | ||
Morganella morganii | ||
Proteus vulgaris | ||
Providencia rettgeri | ||
Pseudomonas aeruginosa | ||
Serratia marcescens |
7
Similarities | ||
---|---|---|
Item | New Device | Predicate Device |
Device Name | ||
(K number) | Colibrí System | |
(K220546) | VITEK 2 Gram Negative Imipenem & | |
VITEK 2 Systems (PC) 5.02 Software | ||
(K103752) | ||
diagnosis of bacterial infections. | ||
The Colibrí System has not been validated for | ||
use in the identification or processing of yeast | ||
species, molds, Nocardia or mycobacteria. | System for the automated quantitative or | |
qualitative susceptibility testing of isolated | ||
colonies for the most clinically significant | ||
aerobic Gram-Negative bacilli, Staphylococcus | ||
spp., Enterococcus spp., Streptococcus | ||
agalactiae, S. pneumoniae and clinically | ||
significant yeast. The VITEK 2 Systems (PC) | ||
5.02 Software is intended for use with VITEK 2 | ||
and VITEK 2 Compact Systems. | ||
Method of testing | Direct testing from isolated colonies. | Direct testing from isolated colonies. |
Sample/Media Type | Isolated bacterial colonies from any patient | |
source. | Isolated bacterial colonies from any patient | |
source. | ||
Acceptable media: |
- Trypticase soy agar with 5% sheep blood
- MacConkey agar
- Columbia blood agar with 5% sheep blood
as whole plate or bi-plate | Acceptable media: - Trypticase soy agar with 5% sheep blood
- MacConkey agar
- Columbia blood agar with 5% sheep blood |
| Solution for Suspension
Preparation | Aqueous 0.45% NaCl Saline Solution (pH 4.5 to
7.0)
3mL volume in the Secondary Tube | Aqueous 0.45% NaCl Saline Solution (pH 4.5 to
7.0)
3mL volume in the Secondary Tube |
| Inoculum density check | The accuracy of the inoculum preparation is
verified by an on-boarding nephelometer. | The accuracy of the inoculum preparation is
verified by a nephelometer. |
| Quality control | Suspension of reference strains to be used as
quality control should be prepared manually
according to the instruction for use of the used
VITEK 2 card. | Suspension of reference strains to be used as
quality control should be prepared manually
according to the instruction for use of the used
VITEK 2 card. |
| AST results
interpretation | MIC and categorization of results are provided
by VITEK 2 | MIC and categorization of results are provided
by VITEK 2 |
Differences | ||
---|---|---|
Item | New Device | Predicate Device |
Device Name | ||
(K number) | Colibrí System | |
(K220546) | VITEK 2 Gram Negative Imipenem & | |
VITEK 2 Systems (PC) 5.02 Software | ||
(K103752) | ||
Colony Selection | The colony to be picked is selected by an | |
operator on a digital plate using the Graphical | ||
User Interface of a Vision System. | The colony to be picked be picked is manually | |
selected by an operator on a real plate through | ||
the visual inspection. | ||
Media Type | Colibrí System is not validated for ChromID CPS | Acceptable media: |
- ChromID CPS |
| Method of Colony
Picking | Colibrí System has been validated for automatic
picking of colonies using a sterile pipette tip. | The colonies to be picked are manually
transferred using a sterile stick or swab. |
| Sample Traceability | On each Secondary Tube prepared by the Colibrí
System, a barcode label is applied including
following data: the sample identification, the
hour of the preparation and the Gram
classification associated to the processed isolate.
Label data are used for sample traceability for
further processing on the VITEK 2. | The sample identification is recorded directly
in the Cassette Docking Station software
manually or scanning the barcode of the
culture media plate from which the colonies
were collected during the preparation of the
microbial suspension. |
| Method of AST
suspension preparation | Using a pipetting system, a predefined number
of morphologically similar colonies are
transferred into Primary Tube containing saline
solution (0.45% NaCl Saline Solution pH 4.5 to
7.0). A homogenous heavy suspension of
organisms is prepared and checked by using on- | Using a sterile stick or swab, a sufficient
number of morphologically similar colonies
are transferred to a saline tube (0.45% NaCl,
Saline Solution pH 4.5 to 7.0). A homogenous
suspension with a density equivalent to the 0.5
McFarland is prepared and checked with the |
8
Differences | |||
---|---|---|---|
Item | New Device | Predicate Device | |
Device Name | |||
(K number) | Colibrí System | ||
(K220546) | VITEK 2 Gram Negative Imipenem & | ||
VITEK 2 Systems (PC) 5.02 Software | |||
(K103752) | |||
board Colibrí nephelometer. In the Secondary | |||
Tube containing 3.0mL of the same saline | |||
solution, a variable aliquot of the heavy | |||
suspension is automatically transferred to obtain | |||
the final microbial concentration according to | |||
IVD package insert indications. The suspensions | |||
prepared by Colibrí System must be tested in | |||
MANUAL MODE on the VITEK 2. | nephelometer. In a second tube containing | ||
3.0mL of saline, a predetermined aliquot of 0.5 | |||
McFarland is transferred according to IVD | |||
package insert indications (MANUAL | |||
MODE). | |||
Alternatively, the 0.5 McFarland suspension | |||
is loaded on the VITEK 2 that automatically | |||
prepares the Secondary Tube at proper | |||
concentration (AUTO DILUTION MODE). |
These differences do not affect substantial equivalence of Colibrí System and the Predicate Device. Both Systems are intended for the AST of microorganisms cultured from human specimens
VII. Performance Data
The following performance data were provided in support of the substantial equivalence determination.
Analytical Studies
The Analytical studies performed with the Colibri System support its use for the preparation of microbial suspension used in conjunction with the bioMérieux VITEK 2 AST analyzer. The Analytical studies demonstrated that the Device can automatically prepare the microbial suspensions at appropriate concentrations, starting from gram-negative and ram-positive bacterial colonies grown on solid culture media, which can be used to hydrate VITEK 2 cards for the determination of susceptibility of organisms to certain drugs. The used methodology (direct colony suspension) and claimed prerequisites for sample preparation are in line with the IVD analyzer manufacturer IFU.
Nephelometer Calibration Verification
To verify the accuracy of the onboard Colibrí System nephelometer in preparing microbial suspensions at specific concentrations within the calibration range, isolated colonies of E. coli (ATCC 25922) grown on non-selective medium were used to manually prepare suspensions at determined concentrations (0.25, 0.5, 1.0, 2.0, 3.0 McFarland), representing the calibration points. For each concentration, 20 suspensions were prepared from three operators in rotation, and the process was repeated on 3 Colibrí Systems calibrated with 3 different lots of suspensions at known concentrations. For each suspension, ten-fold dilutions were prepared and plated in triplicate; to perform viable cell count to calculate the initial tube concentration.
9
A total of 300 suspensions were prepared: overall, 100% of suspensions contained the correct concentration of bacteria considering that a 0.5 McFarland suspension of E. coli has a nominal microbial content of 1-2 × 10° CFU/mL+. The study demonstrated acceptable accuracy.
Pipettor Trueness and Precision
The accuracy and reproducibility of the on-board Colibrí System pipettor was determined gravimetrically. Appropriate vessels were weighted before and after the dispensations of four volumes (50uL, 100 uL, 500uL, 900uL) representing the 5%, 10%, 50% and 90% of the nominal volume of the tip used for the AST preparation. Three Colibrí System pipettors were included in the examination: for each volume, 10 measurements were performed using saline solution (aqueous 0.45%, pH 4.5 to 7.0) and the trueness and reproducibility were calculated. As expected, trueness and reproducibility vary according to the volume under testing but always within the acceptance criteria.
E. coli Suspensions Preparation Verification Study
To assess the ability of the Colibri System to prepare and manage Primary Tubes at various concentrations, isolated colonies of the E. coli ATCC® 25922 were used to automatically prepare Primary Tubes at various turbidities.
A variable number of colonies was selected on the plates images to create different suspensions at increasing turbidity values. Three Colibrí Systems run by three different operators were included in the test.
All the Primary Tubes were correctly managed by Colibrí System according to the turbidity value.
100% suspensions over the entire working range contained the expected number of colonies, estimated considering that the 0.5 McFarland has a nominal content of 1-2 × 108 CFU/mL for E. coli'.
Validation of Colony Picking and Preparation of Microbial Suspensions for AST
The accuracy of colony picking and preparation of the microbial suspension was demonstrated by purity check and bacterial concentration determination of the Primary Tubes.
Three Colibrí Systems were used to prepare Primary Tubes and the respective subculture (Purity Plate) from isolated colonies of 6 bacterial species (3 Gram-Negative and 3 Gram-Positive) grown in 2 polymicrobial mixtures on different types of culture medium in whole and biplates at various incubation time. To confirm nephelometer accuracy, bacterial concentration of the Primary Tube was determined by viable cell count and compared to the theorical concentration, estimated considering that the 0.5 McFarland has a nominal content of 1-2 × 108 CFU/mL for E. coli¹.
1 CLSI guideline M07. 11th ed Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically. Wayne, PA: Clinical and Laboratory Standards Institute, 2018.
10
100% of colonies designated by the operator were picked correctly by the Colibrí System both on whole plates and bi-plates and 100% of Purity Plates showed no evidence of microbial contamination, demonstrating that the Colibrí System accurately picks microbial colonies, without contamination from other microorganisms grown on the same culture plate.
The percentage of prepared suspension with microbial concentration within the acceptable limits was 99.2% and, for each instrument, the result was always >98%. The percentage suspension within acceptable limits has been compared between each instrument with y-test, resulting in no statistically significant difference among the instruments. The results provided evidence that the microbial concentration is accurately measured by the Colibri nephelometer through its turbidity.
AST Challenge Test
The accuracy of MICs obtained by bioMérieux VITEK 2 using Colibrí System for microbial suspensions preparation was evaluated using representative isolates of different species of Enterobacterales (n=62), Staphylococcus (n=16), Streptococcus (n=30), Enterococcus (n=16) and non-fermenters (n=32). The strains included in this study were both susceptible and resistant strains, exhibiting a range of on-scale MIC values toward at least 4 antibiotics representative for the major classes of drugs. Each strain was grown on different agar media (Trypticase Soy Agar + 5% Sheep Blood, MacConkey Agar and Columbia agar+5% sheep blood) at specific incubation times and then processed on three Colibrí System in comparison with the manual preparation.
Microbial suspensions were prepared by Colibrí Preparation Station and processed by the bioMérieux VITEK 2 using the appropriate antibiotic panel. The MICs obtained by bioMérieux VITEK 2 using Colibri System were compared to the MICs obtained by bioMérieux VITEK 2 using manual sample preparation and the SIR category was reported according to the FDA- Recognized Antimicrobial Susceptibility Test Interpretive Criteria. Essential Agreement (EA) of the MICs and Category Agreement (CA) were calculated. The discrepant SIR results were categorized as Very Major Category Error, Major Category Error and Minor Category Error.
11
Agent | Organism group | Total tested | # EA | % EA | Total Evaluable | # EA of Evaluable | % EA of Evaluable | Total cat. | # CA | % CA | # S | # R | # vmj | # maj | # min |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Amikacin | Enterobacterales | 186 | 186 | 100% | 81 | 81 | 100% | 186 | 182 | 97.8% | 141 | 39 | 0 | 0 | 4 |
Amikacin | Non-fermenters | 81 | 81 | 100% | 39 | 39 | 100% | 81 | 79 | 97.5% | 66 | 6 | 0 | 0 | 2 |
Ampicillin | Enterococcus | 48 | 48 | 100% | 4 | 4 | 100% | 48 | 48 | 100% | 36 | 12 | 0 | 0 | 0 |
Ampicillin | Streptococcus | 90 | 90 | 100% | 0 | 0 | N/A | 90 | 90 | 100% | 90 | 0 | 0 | 0 | 0 |
Ampicillin / Sulbactam | Enterobacterales | 111 | 111 | 100% | 9 | 9 | 100% | 111 | 111 | 100% | 21 | 90 | 0 | 0 | 0 |
Ampicillin / Sulbactam | Non-fermenters | 24 | 24 | 100% | 5 | 5 | 100% | 24 | 23 | 95.8% | 15 | 6 | 0 | 0 | 1 |
Aztreonam | Enterobacterales | 186 | 185 | 99.5% | 54 | 54 | 100% | 186 | 185 | 99.5% | 57 | 123 | 0 | 0 | 1 |
Cefepime | Enterobacterales | 186 | 186 | 100% | 58 | 58 | 100% | 186 | 185 | 99.5% | 93 | 54 | 0 | 0 | 1 |
Cefepime | Non-fermenters | 81 | 81 | 100% | 50 | 50 | 100% | 81 | 80 | 98.8% | 48 | 33 | 0 | 1 | 0 |
Cefotaxime | Streptococcus | 90 | 90 | 100% | 0 | 0 | N/A | 90 | 90 | 100% | 90 | 0 | 0 | 0 | 0 |
Cefoxitin | Enterobacterales | 186 | 186 | 100% | 42 | 42 | 100% | 186 | 184 | 98.9% | 36 | 132 | 0 | 0 | 2 |
Ceftazidime | Enterobacterales | 180 | 180 | 100% | 43 | 43 | 100% | 180 | 179 | 99.4% | 33 | 132 | 0 | 0 | 1 |
Ceftazidime | Non-fermenters | 105 | 105 | 100% | 68 | 68 | 100% | 105 | 105 | 100% | 57 | 36 | 0 | 0 | 0 |
Ceftriaxone | Enterobacterales | 186 | 185 | 99.5% | 31 | 30 | 96.8% | 186 | 185 | 99.5% | 36 | 144 | 0 | 0 | 1 |
Ceftriaxone | Streptococcus | 90 | 90 | 100% | 0 | 0 | N/A | 90 | 90 | 100% | 90 | 0 | 0 | 0 | 0 |
Ciprofloxacin | Non-fermenters | 81 | 81 | 100% | 28 | 28 | 100% | 81 | 80 | 98.8% | 51 | 18 | 0 | 0 | 1 |
Ciprofloxacin | Staphylococcus | 48 | 48 | 100% | 6 | 6 | 100% | 48 | 48 | 100% | 33 | 12 | 0 | 0 | 0 |
Clindamycin | Enterococcus | 48 | 48 | 100% | 30 | 30 | 100% | 48 | 47 | 97.9% | 27 | 12 | 0 | 0 | 1 |
Clindamycin | Streptococcus | 90 | 90 | 100% | 2 | 2 | 100% | 90 | 89 | 98.9% | 54 | 33 | 0 | 0 | 1 |
Ertapenem | Enterobacterales | 186 | 186 | 100% | 22 | 22 | 100% | 186 | 184 | 98.9% | 102 | 81 | 0 | 0 | 2 |
Erythromycin | Staphylococcus | 48 | 48 | 100% | 9 | 9 | 100% | 48 | 47 | 97.9% | 21 | 24 | 0 | 0 | 1 |
Erythromycin | Enterococcus | 48 | 48 | 100% | 15 | 15 | 100% | 48 | 48 | 100% | 6 | 30 | 0 | 0 | 0 |
Erythromycin | Streptococcus | 90 | 90 | 100% | 29 | 29 | 100% | 90 | 90 | 100% | 54 | 36 | 0 | 0 | 0 |
Agent | Organism group | Total tested | # EA | % EA | Total Evaluable | # EA of Evaluable | % EA of Evaluable | Total cat. | # CA | % CA | # S | # R | # vmj | # maj | # mi |
Gentamicin | Enterobacterales | 186 | 186 | 100% | 40 | 40 | 100% | 186 | 185 | 99.5% | 108 | 66 | 0 | 0 | 1 |
Gentamicin | Non-fermenters | 81 | 81 | 100% | 27 | 27 | 100% | 81 | 81 | 100% | 54 | 21 | 0 | 0 | 0 |
Imipenem | Staphylococcus | 48 | 48 | 100% | 6 | 6 | 100% | 48 | 48 | 100% | 27 | 21 | 0 | 0 | 0 |
Imipenem | Non-fermenters | 105 | 104 | 99.0% | 54 | 54 | 100% | 105 | 105 | 100% | 72 | 33 | 0 | 0 | 0 |
Levofloxacin | Enterobacterales | 186 | 186 | 100% | 47 | 47 | 100% | 186 | 183 | 98.4% | 69 | 99 | 0 | 0 | 3 |
Levofloxacin | Non-fermenters | 81 | 81 | 100% | 63 | 63 | 100% | 81 | 79 | 97.5% | 42 | 27 | 0 | 0 | 2 |
Levofloxacin | Staphylococcus | 33 | 33 | 100% | 14 | 14 | 100% | 33 | 32 | 97.0% | 27 | 6 | 0 | 0 | 1 |
Levofloxacin | Enterococcus | 48 | 48 | 100% | 41 | 41 | 100% | 48 | 47 | 97.9% | 27 | 6 | 0 | 0 | 1 |
Linezolid | Streptococcus | 90 | 90 | 100% | 90 | 90 | 100% | 90 | 90 | 100% | 87 | 0 | 0 | 0 | 0 |
Linezolid | Staphylococcus | 48 | 48 | 100% | 48 | 48 | 100% | 48 | 48 | 100% | 48 | 0 | 0 | 0 | 0 |
Linezolid | Enterococcus | 48 | 48 | 100% | 48 | 48 | 100% | 48 | 47 | 97.9% | 45 | 0 | 0 | 0 | 1 |
Linezolid | Streptococcus | 90 | 90 | 100% | 0 | 0 | N/A | 90 | 90 | 100% | 90 | 0 | 0 | 0 | 0 |
Meropenem | Enterobacterales | 186 | 186 | 100% | 26 | 26 | 100% | 186 | 184 | 98.9% | 111 | 72 | 0 | 0 | 2 |
Meropenem | Non-fermenters | 105 | 105 | 100% | 64 | 64 | 100% | 105 | 105 | 100% | 72 | 27 | 0 | 0 | 0 |
Moxifloxacin | Staphylococcus | 48 | 48 | 100% | 12 | 12 | 100% | 48 | 48 | 100% | 39 | 6 | 0 | 0 | 0 |
Nitrofurantoin | Enterobacterales | 186 | 186 | 100% | 134 | 134 | 100% | 186 | 184 | 98.9% | 51 | 90 | 0 | 0 | 2 |
Nitrofurantoin | Staphylococcus | 48 | 48 | 100% | 2 | 2 | 100% | 48 | 48 | 100% | 48 | 0 | 0 | 0 | 0 |
Oxacillin | Enterococcus | 48 | 48 | 100% | 27 | 27 | 100% | 48 | 47 | 97.9% | 24 | 15 | 0 | 0 | 1 |
Oxacillin | Staphylococcus | 48 | 48 | 100% | 13 | 13 | 100% | 48 | 48 | 100% | 21 | 27 | 0 | 0 | 0 |
Penicillin (Benzyl-penicillin) | Enterococcus | 48 | 48 | 100% | 38 | 38 | 100% | 48 | 48 | 100% | 33 | 15 | 0 | 0 | 0 |
Penicillin (Benzyl-penicillin) | Streptococcus | 90 | 90 | 100% | 25 | 25 | 100% | 90 | 90 | 100% | 90 | 0 | 0 | 0 | 0 |
Piperacillin / Tazobactam | Staphylococcus | 48 | 48 | 100% | 11 | 11 | 100% | 48 | 48 | 100% | 12 | 36 | 0 | 0 | 0 |
Piperacillin / Tazobactam | Enterobacterales | 177 | 177 | 100% | 29 | 29 | 100% | 177 | 176 | 99.4% | 60 | 111 | 0 | 0 | 1 |
Piperacillin / Tazobactam | Non-fermenters | 105 | 105 | 100% | 52 | 52 | 100% | 105 | 103 | 98.1% | 57 | 30 | 0 | 0 | 2 |
Quinupristin / Dalfopristin | Staphylococcus | 48 | 48 | 100% | 16 | 16 | 100% | 48 | 48 | 100% | 45 | 3 | 0 | 0 | 0 |
Agent | Organism group | Total tested | # EA | % EA | Total Evaluable | # EA of Evaluable | % EA of Evaluable | Total cat. | # CA | % CA | # S | # R | # vmj | # maj | # min |
Tetracycline | Enterobacterales | 186 | 186 | 100% | 54 | 54 | 100% | 186 | 184 | 98.9% | 90 | 87 | 0 | 0 | 2 |
Staphylococcus | 48 | 48 | 100% | 7 | 7 | 100% | 48 | 48 | 100% | 30 | 18 | 0 | 0 | 0 | |
Enterococcus | 48 | 48 | 100% | 0 | 0 | N/A | 48 | 48 | 100% | 15 | 33 | 0 | 0 | 0 | |
Streptococcus | 42 | 42 | 100% | 0 | 0 | N/A | 42 | 42 | 100% | 39 | 3 | 0 | 0 | 0 | |
Tigecycline | Enterobacterales | 186 | 186 | 100% | 104 | 104 | 100% | 186 | 183 | 98.4% | 144 | 18 | 0 | 0 | 3 |
Staphylococcus | 33 | 33 | 100% | 0 | 0 | N/A | 33 | 33 | 100% | 33 | 0 | 0 | 0 | 0 | |
Enterococcus | 21 | 21 | 100% | 0 | 0 | N/A | 21 | 21 | 100% | 21 | 0 | 0 | 0 | 0 | |
Streptococcus | 90 | 90 | 100% | 2 | 2 | 100% | 90 | 90 | 100% | 90 | 0 | 0 | 0 | 0 | |
Tobramycin | Enterobacterales | 186 | 186 | 100% | 42 | 42 | 100% | 186 | 185 | 99.5% | 51 | 108 | 0 | 0 | 1 |
Non-fermenters | 81 | 81 | 100% | 1 | 1 | 100% | 81 | 80 | 98.8% | 57 | 24 | 0 | 0 | 1 | |
Trimethoprim / Sulfamethoxazole | Enterobacterales | 186 | 186 | 100% | 3 | 3 | 100% | 186 | 186 | 100% | 63 | 123 | 0 | 0 | 0 |
Vancomycin | Staphylococcus | 48 | 48 | 100% | 35 | 35 | 100% | 48 | 48 | 100% | 45 | 0 | 0 | 0 | 0 |
Enterococcus | 48 | 48 | 100% | 18 | 18 | 100% | 48 | 48 | 100% | 30 | 18 | 0 | 0 | 0 | |
Streptococcus | 90 | 89 | 98.9% | 65 | 65 | 100% | 90 | 90 | 100% | 90 | 0 | 0 | 0 | 0 |
AST Challenge Study summary of results, antimicrobial agent
12
13
14
| Group | Incub. time | Total
tested | # EA | % EA | Total
Evaluable | # EA of
Evaluable | % EA of
Evaluable | Total
cat. | # CA | % CA | # S | # R | # vmj | # maj | # min |
|------------------|-------------|-----------------|------|-------|--------------------|----------------------|----------------------|---------------|------|-------|-----|-----|-------|-------|-------|
| Enterobacterales | 14 h | 1383 | 1382 | 99.9% | 361 | 361 | 100% | 1383 | 1373 | 99.3% | 561 | 735 | 0 | 0 | 10 |
| | 24 h | 1689 | 1688 | 99.9% | 458 | 457 | 99.8% | 1689 | 1672 | 99.0% | 705 | 834 | 0 | 0 | 17 |
| Non-fermenters | 14 h | 420 | 420 | 100% | 200 | 200 | 100% | 420 | 416 | 99.0% | 252 | 126 | 0 | 0 | 4 |
| | 24 h | 510 | 509 | 99.8% | 251 | 251 | 100% | 510 | 504 | 98.8% | 339 | 135 | 0 | 1 | 5 |
| Staphylococcus | 18 h | 594 | 594 | 100% | 179 | 179 | 100% | 594 | 592 | 99.7% | 429 | 153 | 0 | 0 | 2 |
| Enterococcus | 18 h | 453 | 453 | 100% | 221 | 221 | 100% | 453 | 449 | 99.1% | 264 | 141 | 0 | 0 | 4 |
| Streptococcus | 18 h | 942 | 941 | 99.9% | 213 | 213 | 100% | 942 | 941 | 99.9% | 864 | 72 | 0 | 0 | 1 |
AST Challenge Study summary of results, organism group
15
MICs obtained using Colibrí System for microbial suspensions preparation showed very high agreement with the manual preparation for all the microorganisms group; overall, 1882/1883 evaluable MIC results were within one doubling dilution of the comparator method result and 5947/5991SIR categorizations were in agreement. The overall Essential Agreement of the evaluable MIC results was > 99.9% and the Category Agreement was 99.3%.
Reproducibility Study
The Reproducibility Study was performed to demonstrate consistency of AST results given by bioMérieux VITEK 2 on microbial suspensions prepared by different Colibrí Systems in different test days.
Culture media showing isolated colonies of different Gram-Positive and Gram-Negative strains were processed on three Colibrí Systems run by three operators over 3 days. Each microorganism was tested with the appropriate antibiotic panel following the analyzer's instructions for use. Each condition was tested in triplicate for a total number of 81 replicates for each combination strainantimicrobial agent.
The MIC results were considered reproducible if they fell within one doubling dilution from the modal value of each combination strain-antimicrobial agent
The results were reproducible for each antimicrobial agent between instruments, operators and days.
Antibiotic | Colibrí System | Best caseª (%) | Worst case (%) |
---|---|---|---|
Ampicillin- | |||
Sulbactam | Instrument 1 | 27/27 (100%) | 27/27 (100%) |
Instrument 2 | 27/27 (100%) | 27/27 (100%) | |
Instrument 3 | 27/27 (100%) | 27/27 (100%) | |
Combined | 81/81 (100%) | 81/81 (100%) | |
Piperacillin/ | |||
Tazobactam | Instrument 1 | 134/135 (99.3%) | 133/135 (98.5%) |
Instrument 2 | 133/135 (98.5%) | 132/135 (97.8%) | |
Instrument 3 | 135/135 (100%) | 133/135 (98.5%) | |
Combined | 402/405 (99.3%) | 398/405 (98.3%) | |
Cefoxitin | Instrument 1 | 81/81 (100%) | 79/81 (97.5%) |
Instrument 2 | 81/81 (100%) | 80/81 (98.8%) | |
Instrument 3 | 80/81 (98.8%) | 79/81 (97.5%) | |
Combined | 242/243 (99.6%) | 238/243 (97.9%) | |
Ceftazidime | Instrument 1 | 187/189 (98.9%) | 186/189 (98.4%) |
Instrument 2 | 189/189 (100%) | 189/189 (100%) | |
Instrument 3 | 188/189 (99.5%) | 188/189 (99.5%) | |
Combined | 564/567 (99.5%) | 563/567 (99.3%) | |
Ceftriaxone | Instrument 1 | 27/27 (100%) | 27/27 (100%) |
Instrument 2 | 27/27 (100%) | 27/27 (100%) | |
Instrument 3 | 27/27 (100%) | 27/27 (100%) | |
Combined | 81/81 (100%) | 81/81 (100%) | |
Cefepime | Instrument 1 | 162/162 (100%) | 162/162 (100%) |
Instrument 2 | 162/162 (100%) | 162/162 (100%) |
Summary of reproducibility results - Gram-negatives Organisms Stratified by Antibiotic | ||||
---|---|---|---|---|
16
Antibiotic | Colibrí System | Best caseª (%) | Worst caseᵇ (%) |
---|---|---|---|
Aztreonam | Instrument 1 | 81/81 (100%) | 81/81 (100%) |
Instrument 2 | 81/81 (100%) | 81/81 (100%) | |
Instrument 3 | 81/81 (100%) | 81/81 (100%) | |
Combined | 243/243 (100%) | 243/243 (100%) | |
Meropenem | Instrument 1 | 108/108 (100%) | 108/108 (100%) |
Instrument 2 | 108/108 (100%) | 108/108 (100%) | |
Instrument 3 | 108/108 (100%) | 108/108 (100%) | |
Combined | 324/324 (100%) | 324/324 (100%) | |
Amikacin | Instrument 1 | 189/189 (100%) | 189/189 (100%) |
Instrument 2 | 189/189 (100%) | 189/189 (100%) | |
Instrument 3 | 188/189 (99.5%) | 188/189 (99.5%) | |
Combined | 566/567 (99.8%) | 566/567 (99.8%) | |
Gentamicin | Instrument 1 | 81/81 (100%) | 81/81 (100%) |
Instrument 2 | 81/81 (100%) | 81/81 (100%) | |
Instrument 3 | 81/81 (100%) | 81/81 (100%) | |
Combined | 243/243 (100%) | 243/243 (100%) | |
Tobramycin | Instrument 1 | 27/27 (100%) | 26/27 (96.3%) |
Instrument 2 | 27/27 (100%) | 27/27 (100%) | |
Instrument 3 | 27/27 (100%) | 26/27 (96.3%) | |
Combined | 81/81 (100%) | 79/81 (97.5%) | |
Levofloxacin | Instrument 1 | 81/81 (100%) | 81/81 (100%) |
Instrument 2 | 80/81 (98.8%) | 80/81 (98.8%) | |
Instrument 3 | 80/81 (98.8%) | 80/81 (98.8%) | |
Combined | 241/243 (99.2%) | 241/243 (99.2%) | |
Tetracycline | Instrument 1 | 54/54 (100%) | 54/54 (100%) |
Instrument 2 | 54/54 (100%) | 54/54 (100%) | |
Instrument 3 | 54/54 (100%) | 54/54 (100%) | |
Combined | 162/162 (100%) | 162/162 (100%) | |
Tigecycline | Instrument 1 | 81/81 (100%) | 80/81 (98.8%) |
Instrument 2 | 81/81 (100%) | 80/81 (98.8%) | |
Instrument 3 | 81/81 (100%) | 80/81 (98.8%) | |
Combined | 243/243 (100%) | 240/243 (98.8%) | |
Nitrofurantoin | Instrument 1 | 135/135 (100%) | 135/135 (100%) |
Instrument 2 | 135/135 (100%) | 134/135 (99.3%) | |
Instrument 3 | 134/135 (99.3%) | 134/135 (99.3%) | |
Combined | 404/405 (99.8%) | 403/405 (99.5%) | |
Imipenem | Instrument 1 | 27/27 (100%) | 27/27 (100%) |
Instrument 2 | 27/27 (100%) | 27/27 (100%) | |
Instrument 3 | 27/27 (100%) | 27/27 (100%) | |
Combined | 81/81 (100%) | 81/81 (100%) | |
Ciprofloxacin | Instrument 1 | 27/27 (100%) | 27/27 (100%) |
Instrument 2 | 27/27 (100%) | 26/27 (96.3%) | |
Instrument 3 | 27/27 (100%) | 27/27 (100%) | |
Combined | 81/81 (100%) | 80/81 (98.8%) | |
Antibiotic | Colibrí System | Best case (%) | Worst case (%) |
Levofloxacin | Instrument 1 | 243/243 (100%) | 243/243 (100%) |
Instrument 2 | 241/243 (99.2%) | 241/243 (99.2%) | |
Instrument 3 | 241/243 (99.2%) | 241/243 (99.2%) | |
Combined | 725/729 (99.5%) | 725/729 (99.5%) | |
Tetracycline | Instrument 1 | 27/27 (100%) | 27/27 (100%) |
Instrument 2 | 27/27 (100%) | 26/27 (96.3%) | |
Instrument 3 | 27/27 (100%) | 27/27 (100%) | |
Combined | 81/81 (100%) | 80/81 (98.8%) | |
Tigecycline | Instrument 1 | 27/27 (100%) | 27/27 (100%) |
Instrument 2 | 27/27 (100%) | 27/27 (100%) | |
Instrument 3 | 27/27 (100%) | 27/27 (100%) | |
Combined | 81/81 (100%) | 81/81 (100%) | |
Nitrofurantoin | Instrument 1 | 54/54 (100%) | 54/54 (100%) |
Instrument 2 | 54/54 (100%) | 54/54 (100%) | |
Instrument 3 | 54/54 (100%) | 54/54 (100%) | |
Combined | 162/162 (100%) | 162/162 (100%) | |
Ciprofloxacin | Instrument 1 | 81/81 (100%) | 81/81 (100%) |
Instrument 2 | 81/81 (100%) | 81/81 (100%) | |
Instrument 3 | 81/81 (100%) | 81/81 (100%) | |
Combined | 243/243 (100%) | 243/243 (100%) | |
Penicillin | |||
(Benzylpenicillin) | Instrument 1 | 162/162 (100%) | 160/162 (98.8%) |
Instrument 2 | 162/162 (100%) | 159/162 (98.1%) | |
Instrument 3 | 161/162 (99.4%) | 159/162 (98.1%) | |
Combined | 485/486 (99.8%) | 478/486 (98.4%) | |
Ampicillin | Instrument 1 | 27/27 (100%) | 27/27 (100%) |
Instrument 2 | 27/27 (100%) | 27/27 (100%) | |
Instrument 3 | 27/27 (100%) | 27/27 (100%) | |
Combined | 81/81 (100%) | 81/81 (100%) | |
Oxacillin | Instrument 1 | 27/27 (100%) | 27/27 (100%) |
Instrument 2 | 27/27 (100%) | 26/27 (96.3%) | |
Instrument 3 | 27/27 (100%) | 26/27 (96.3%) | |
Combined | 81/81 (100%) | 79/81 (97.5%) | |
Erythromycin | Instrument 1 | 108/108 (100%) | 107/108 (99.1%) |
Instrument 2 | 108/108 (100%) | 108/108 (100%) | |
Instrument 3 | 108/108 (100%) | 107/108 (99.1%) | |
Combined | 324/324 (100%) | 322/324 (99.4%) | |
Quinupristin/ | |||
Dalfopristin | Instrument 1 | 54/54 (100%) | 52/54 (96.3%) |
Instrument 2 | 54/54 (100%) | 53/54 (98.1%) | |
Instrument 3 | 54/54 (100%) | 54/54 (100%) | |
Combined | 162/162 (100%) | 159/162 (98.1%) | |
Linezolid | Instrument 1 | 108/108 (100%) | 108/108 (100%) |
Instrument 2 | 108/108 (100%) | 108/108 (100%) | |
Instrument 3 | 108/108 (100%) | 108/108 (100%) | |
Combined | 324/324 (100%) | 324/324 (100%) | |
Vancomycin | Instrument 1 | 189/189 (100%) | 188/189 (99.5%) |
Instrument 2 | 189/189 (100%) | 188/189 (99.5%) | |
Instrument 3 | 189/189 (100%) | 188/189 (99.5%) | |
Combined | 567/567 (100%) | 564/567 (99.5%) | |
Antibiotic | Colibrí System | Best case (%) | Worst case (%) |
Instrument 3 | 189/189 (100%) | 188/189 (99.5%) | |
Combined | 567/567 (99.2%) | 564/567 (99.5%) |
ªCalculated assuming the off-scale results are within one well from the mode.
bCalculated assuming the off-scale results are greater than one well from the mode.
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Summary of reproducibility results – Gram-positives Organisms Stratified by Antibiotic
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a Calculated assuming the off-scale results are within one well from the mode. bCalculated assuming the off-scale results are greater than one well from the mode.
Purity Plate Growth
In total, 2,364 purity plates have been prepared by different Colibri™ Preparation Station throughout the analytical studies used to support the AST microbial suspension function of the Colibrí System, starting from Secondary Tubes of VITEK® 2, inoculated with various microbial strains. All the purity plates (2364/2364, 100%) were correctly processed and provided evidence of microbial contamination of the Secondary Tubes, demonstrating that Colibri™ Preparation Station is able to prepare monomicrobial suspensions by picking precisely the designated colonies from the culture plates and to prevent the cross-contamination between the specimens.
Sample preparation for Quality Control
The study was performed to demonstrate the reproducibility of MIC results for AST Quality Control organisms listed in CLSI M100 using the Colibrí System as suspension preparator.
The sample preparation for Quality Control was conducted daily at the beginning of the working session on each instrument involved in the Analytical Studies. All instruments were used to prepare bacterial suspensions then tested using the appropriate AST panel. MIC values for each drug/organism combination were compared to the established ranges reported in the AST analyzer labeling, resulting in 100% in-range MIC values. Purity of all the suspensions was confirmed by Purity Plates prepared by Colibrí System. The summary of results is in the table below.
Electrical safety and electromagnetic compatibility (EMC)
Electrical safety and EMC testing were conducted on the Colibrí System, consisting of Colibrí Vision System and Colibrí Preparation Station. The system complies with the IEC 61010-1: 2010, IEC 61010-2-081: 2015, IEC 61010-2-101: 2015 standards for safety and the IEC 61326-1: 2012, IEC 61326-2-6: 2012 and IEC 60601-1-2:2014 standards for EMC; test reports are included.
Laser Product
Colibrí System complies with the IEC 60825-1: 2007 standard; test report is included.
Software Verification and Validation Testing
Software verification and validation testing were conducted according to the internal Standard Operative Procedure in agreement with IEC 62304 Edition 1.1 2015-06 Consolidate version. Documentation was provided as recommended by FDA's Guidance for Industry and FDA Staff, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices"
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issued on May 11, 2005. The software for the Device was considered as a "Moderate" level of concern, since a failure or latent design flaw could directly through incorrect or delayed information or through the action of a care provider result in minor injury to the patient or operator.
Usability validation
Usability has been addressed for Colibri System following recommendations in the "Guidance for Industry and Food and Drug Administration Staff - Applying Human Factors and Usability Engineering to Medical Devices (February 3, 2016)" and in agreement with "IEC 62366-1:2015-02 Medical Devices - Part 1: Application Of Usability Engineering To Medical Devices [Including CORRIGENDUM 1 (2016)]".
The results of usability validation provided evidence that all the measurements implemented to prevent use errors, regarding the device design, labelling and training, are effective and the device can be used in a safe and effective way, establishing that all the risks included in the Risk Analysis have been mitigated and there are no Unacceptable residual risks.
VIII. Non-Clinical and/or Clinical Tests Summary & Conclusions
Conclusions:
All the necessary safety tests were performed and documented. We have verified and validated that the Copan Colibrí System meets its functional specifications and performance requirements, and complies with applicable international standards IEC 61010-1, IEC 61010-2:101, IEC 61010-2:081, IEC 60825-1, IEC 61326-1, IEC 61326-2:6, IEC 60601-1-2:2014, CLSI M100, CLSI M52, CLSI M52, IEC 62304 and IEC 62366-1.
The Analytical Studies results demonstrated that the Colibrí System when used in conjunction with its parental devices is as safe, as effective, and performs as well as the predicate device. The minor differences between the devices do not adversely affect safety and effectiveness. The used methodology (direct colony suspension) and claimed prerequisites for sample preparation are in line with the IVD analyzer manufacturer IFU and with the relevant CLSI guidance.