Diagnostic performance of the Xpert Carba-R assay for active surveillance of rectal carbapenemase-producing organisms in intensive care unit patients.
Bacteria
/ genetics
Bacterial Infections
/ diagnosis
Bacterial Proteins
/ genetics
Bacteriological Techniques
Carrier State
/ epidemiology
Early Diagnosis
Female
Humans
Intensive Care Units
Male
Patient Admission
Population Surveillance
Prevalence
Reagent Kits, Diagnostic
Rectum
/ microbiology
Republic of Korea
/ epidemiology
Retrospective Studies
Sensitivity and Specificity
beta-Lactamases
/ genetics
Carbapenemase
Chromogenic culture
Gram-negative bacteria
Intensive care unit
Molecular methods
Surveillance
Xpert Carba-R assay
Journal
Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411
Informations de publication
Date de publication:
2019
2019
Historique:
received:
04
04
2019
accepted:
16
07
2019
entrez:
7
8
2019
pubmed:
7
8
2019
medline:
26
6
2020
Statut:
epublish
Résumé
There are growing concerns regarding the spread of carbapenemase-producing organisms (CPOs) among patients in long-term care facilities (LTCFs) and hospitals in South Korea. We have established a screening protocol for the detection of CPOs in high-risk patients upon admission to intensive care units (ICUs). The diagnostic performance of the Xpert Carba-R assay was compared to that of rectal culture for CPO detection in high-risk patients upon ICU admission. A total of 408 consecutive rectal swabs were obtained from December 2016 to December 2017. CPO screening was performed using the Xpert Carba-R assay (Cepheid, Sunnyvale, CA, USA). When a carbapenemase gene was detected, additional rectal swabs were incubated overnight and inoculated on chromID CARBA medium (bioMérieux, Marcy l'Etoile, France). Bacterial carbapenemase genes, including The prevalence of CPO carriage was 7.4% according to the Carba-R assay and 3.7% according to rectal culture. The median Ct values of IMP-1 and KPC were significantly different (35.2 vs. 26.6, We demonstrated the prevalence of CPO carriage in high-risk patients upon ICU admission and evaluated the diagnostic performance of the Carba-R assay. The combined use of the Xpert Carba-R assay and culture produces rapid and reliable results for the active surveillance of rectal CPO in ICU patients.
Sections du résumé
Background
There are growing concerns regarding the spread of carbapenemase-producing organisms (CPOs) among patients in long-term care facilities (LTCFs) and hospitals in South Korea. We have established a screening protocol for the detection of CPOs in high-risk patients upon admission to intensive care units (ICUs). The diagnostic performance of the Xpert Carba-R assay was compared to that of rectal culture for CPO detection in high-risk patients upon ICU admission.
Methods
A total of 408 consecutive rectal swabs were obtained from December 2016 to December 2017. CPO screening was performed using the Xpert Carba-R assay (Cepheid, Sunnyvale, CA, USA). When a carbapenemase gene was detected, additional rectal swabs were incubated overnight and inoculated on chromID CARBA medium (bioMérieux, Marcy l'Etoile, France). Bacterial carbapenemase genes, including
Results
The prevalence of CPO carriage was 7.4% according to the Carba-R assay and 3.7% according to rectal culture. The median Ct values of IMP-1 and KPC were significantly different (35.2 vs. 26.6,
Conclusions
We demonstrated the prevalence of CPO carriage in high-risk patients upon ICU admission and evaluated the diagnostic performance of the Carba-R assay. The combined use of the Xpert Carba-R assay and culture produces rapid and reliable results for the active surveillance of rectal CPO in ICU patients.
Identifiants
pubmed: 31384432
doi: 10.1186/s13756-019-0579-2
pii: 579
pmc: PMC6664486
doi:
Substances chimiques
Bacterial Proteins
0
Reagent Kits, Diagnostic
0
beta-Lactamases
EC 3.5.2.6
carbapenemase
EC 3.5.2.6
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
127Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no competing interests.
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