Prospective evaluation of a screening algorithm for carbapenemase-producing Enterobacteriaceae.
Algorithms
Anti-Bacterial Agents
/ pharmacology
Carbapenem-Resistant Enterobacteriaceae
/ chemistry
Enterobacteriaceae Infections
/ diagnosis
Humans
Microbial Sensitivity Tests
Molecular Typing
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
carbapenem
carbapenemase-producing Enterobacteriaceae
prospective
resistance
screening algorithm
Journal
Journal of clinical laboratory analysis
ISSN: 1098-2825
Titre abrégé: J Clin Lab Anal
Pays: United States
ID NLM: 8801384
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
13
08
2018
revised:
05
10
2018
accepted:
07
10
2018
pubmed:
6
11
2018
medline:
30
4
2019
entrez:
4
11
2018
Statut:
ppublish
Résumé
Carbapenemase-producing Enterobacteriaceae (CPE) have become a major public health issue. The objective of the present study was to prospectively assess the analytical performance of a CPE detection algorithm based on phenotypic tests (the screening test) and MALDI-ToF hydrolysis (the confirmatory test). Over a 6-month period and based on a disk diffusion method, 74 carbapenem-resistant strains were included in this study. Of the collected isolates, 54 turned out to be negative after phenotypic tests. Hence, 20 strains (including all of the CPEs) were checked with the confirmation test. Seven strains were positive. After molecular biology assessments in a reference center, three of the seven were found to be false positives. The algorithm had a negative predictive value and a sensitivity of 100%, a specificity of 77%, and a positive predictive value of 20%. The algorithm has a 24-hour turnaround time and helps to avoid using expensive molecular biology tests; we consider that it can be used on a routine basis for screening clinical strains.
Sections du résumé
BACKGROUND
BACKGROUND
Carbapenemase-producing Enterobacteriaceae (CPE) have become a major public health issue. The objective of the present study was to prospectively assess the analytical performance of a CPE detection algorithm based on phenotypic tests (the screening test) and MALDI-ToF hydrolysis (the confirmatory test).
METHODS
METHODS
Over a 6-month period and based on a disk diffusion method, 74 carbapenem-resistant strains were included in this study.
RESULTS
RESULTS
Of the collected isolates, 54 turned out to be negative after phenotypic tests. Hence, 20 strains (including all of the CPEs) were checked with the confirmation test. Seven strains were positive. After molecular biology assessments in a reference center, three of the seven were found to be false positives. The algorithm had a negative predictive value and a sensitivity of 100%, a specificity of 77%, and a positive predictive value of 20%.
CONCLUSION
CONCLUSIONS
The algorithm has a 24-hour turnaround time and helps to avoid using expensive molecular biology tests; we consider that it can be used on a routine basis for screening clinical strains.
Identifiants
pubmed: 30390351
doi: 10.1002/jcla.22706
pmc: PMC6818548
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e22706Informations de copyright
© 2018 Wiley Periodicals, Inc.
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