Carbapenemase production among less-common Enterobacterales genera: 10 US sites, 2018.


Journal

JAC-antimicrobial resistance
ISSN: 2632-1823
Titre abrégé: JAC Antimicrob Resist
Pays: England
ID NLM: 101765283

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 11 05 2021
accepted: 30 07 2021
entrez: 13 9 2021
pubmed: 14 9 2021
medline: 14 9 2021
Statut: epublish

Résumé

Historically, United States' carbapenem-resistant Enterobacterales (CRE) surveillance and mechanism testing focused on three genera: From January through May 2018, we conducted a 10 state evaluation to assess the contribution of less common genera (LCG) to carbapenemase-producing (CP) CRE. State public health laboratories (SPHLs) requested participating clinical laboratories submit all Enterobacterales from all specimen sources during the surveillance period that were resistant to any carbapenem (Morganellaceae required resistance to doripenem, ertapenem, or meropenem) or were CP based on phenotypic or genotypic testing at the clinical laboratory. SPHLs performed species identification, phenotypic carbapenemase production testing, and molecular testing for carbapenemases to identify CP-CRE. Isolates were categorized as CP if they demonstrated phenotypic carbapenemase production and ≥1 carbapenemase gene ( SPHLs tested 868 CRE isolates, 127 (14.6%) were from eight LCG. Overall, 195 (26.3%) EsKE isolates were CP-CRE, compared with 24 (18.9%) LCG isolates. LCG accounted for 24 (11.0%) of 219 CP-CRE identified. Participating sites would have missed approximately 1 in 10 CP-CRE if isolate submission had been limited to EsKE genera. Expanding mechanism testing to additional genera could improve detection and prevention efforts.

Sections du résumé

BACKGROUND BACKGROUND
Historically, United States' carbapenem-resistant Enterobacterales (CRE) surveillance and mechanism testing focused on three genera:
OBJECTIVES OBJECTIVE
From January through May 2018, we conducted a 10 state evaluation to assess the contribution of less common genera (LCG) to carbapenemase-producing (CP) CRE.
METHODS METHODS
State public health laboratories (SPHLs) requested participating clinical laboratories submit all Enterobacterales from all specimen sources during the surveillance period that were resistant to any carbapenem (Morganellaceae required resistance to doripenem, ertapenem, or meropenem) or were CP based on phenotypic or genotypic testing at the clinical laboratory. SPHLs performed species identification, phenotypic carbapenemase production testing, and molecular testing for carbapenemases to identify CP-CRE. Isolates were categorized as CP if they demonstrated phenotypic carbapenemase production and ≥1 carbapenemase gene (
RESULTS RESULTS
SPHLs tested 868 CRE isolates, 127 (14.6%) were from eight LCG. Overall, 195 (26.3%) EsKE isolates were CP-CRE, compared with 24 (18.9%) LCG isolates. LCG accounted for 24 (11.0%) of 219 CP-CRE identified.
CONCLUSIONS CONCLUSIONS
Participating sites would have missed approximately 1 in 10 CP-CRE if isolate submission had been limited to EsKE genera. Expanding mechanism testing to additional genera could improve detection and prevention efforts.

Identifiants

pubmed: 34514407
doi: 10.1093/jacamr/dlab137
pii: dlab137
pmc: PMC8417453
doi:

Types de publication

Journal Article

Langues

eng

Pagination

dlab137

Informations de copyright

Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy 2021. This work is written by a US Government employee and is in the public domain in the US.

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Auteurs

Alicia Shugart (A)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.

Garrett Mahon (G)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.

Jennifer Y Huang (JY)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.

Maria Karlsson (M)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.

Ann Valley (A)

Wisconsin State Laboratory of Hygiene, Madison, WI, USA.

Megan Lasure (M)

Wisconsin State Laboratory of Hygiene, Madison, WI, USA.

Annastasia Gross (A)

Minnesota Department of Health, St Paul, MN, USA.

Brittany Pattee (B)

Minnesota Department of Health, St Paul, MN, USA.

Elisabeth Vaeth (E)

Maryland Department of Health, Baltimore, MD, USA.

Richard Brooks (R)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.
Maryland Department of Health, Baltimore, MD, USA.

Tyler Maruca (T)

Maryland Department of Health, Baltimore, MD, USA.

Catherine E Dominguez (CE)

Maryland Department of Health, Baltimore, MD, USA.

David Torpey (D)

Maryland Department of Health, Baltimore, MD, USA.

Drew Francis (D)

Arizona Department of Health Services, Phoenix, AZ, USA.

Rachana Bhattarai (R)

Arizona Department of Health Services, Phoenix, AZ, USA.

Marion A Kainer (MA)

Tennessee Department of Health, Nashville, TN, USA.

Allison Chan (A)

Tennessee Department of Health, Nashville, TN, USA.

Heather Dubendris (H)

North Carolina Department of Health and Human Services, Raleigh, NC, USA.

Shermalyn R Greene (SR)

North Carolina Department of Health and Human Services, Raleigh, NC, USA.

Sara J Blosser (SJ)

Indiana State Department of Health, Indianapolis, IN, USA.

D J Shannon (DJ)

Indiana State Department of Health, Indianapolis, IN, USA.

Kelly Jones (K)

Michigan Department of Health and Human Services, Lansing, MI, USA.

Brenda Brennan (B)

Michigan Department of Health and Human Services, Lansing, MI, USA.

Sopheay Hun (S)

Washington State Department of Health, Tumwater, WA, USA.

Marisa D'Angeli (M)

Washington State Department of Health, Tumwater, WA, USA.

Caitlin N Murphy (CN)

University of Nebraska Medical Center, Department of Pathology and Microbiology, Omaha, NE, USA.

Maureen Tierney (M)

Nebraska Department of Health and Human Services, Lincoln, NE, USA.

Natashia Reese (N)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.

Amelia Bhatnagar (A)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.
Goldbelt C6 Inc, Juneau, AK, USA.

Alex Kallen (A)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.

Allison C Brown (AC)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.

Maroya Spalding Walters (M)

Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA, USA.

Classifications MeSH