Detection of colonization by carbapenemase-producing Gram-negative Bacilli in patients by use of the Xpert MDRO assay.

نویسندگان

  • Fred C Tenover
  • Rafael Canton
  • JoAnn Kop
  • Ryan Chan
  • Jamie Ryan
  • Fred Weir
  • Patricia Ruiz-Garbajosa
  • Vincent LaBombardi
  • David H Persing
چکیده

Detecting colonization of patients with carbapenemase-producing bacteria can be difficult. This study compared the sensitivity and specificity of a PCR-based method (Xpert MDRO) for detecting blaKPC, blaNDM, and blaVIM carbapenem resistance genes using GeneXpert cartridges to the results of culture with and without a broth enrichment step on 328 rectal, perirectal, and stool samples. The culture method included direct inoculation of a MacConkey agar plate on which a 10-μg meropenem disk was placed and plating on MacConkey agar after overnight enrichment of the sample in MacConkey broth containing 1 μg/ml of meropenem. Forty-three (13.1%) samples were positive by PCR for blaKPC and 11 (3.4%) were positive for blaVIM; none were positive for blaNDM. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PCR assay for blaKPC were 100%, 99.0%, 93.0%, and 100%, respectively, compared to broth enrichment culture and sequencing of target genes. The sensitivity, specificity, PPV, and NPV of the assay for blaVIM were 100%, 99.4%, 81.8%, and 100%, respectively. Since none of the clinical samples contained organisms with blaNDM, 66 contrived stool samples were prepared at various dilutions using three Klebsiella pneumoniae isolates containing blaNDM. The PCR assay showed 100% positivity at dilutions from 300 to 1,800 CFU/ml and 93.3% at 150 CFU/ml. The Xpert MDRO PCR assay required 2 min of hands-on time and 47 min to complete. Rapid identification of patients colonized with carbapenemase-producing organisms using multiplex PCR may help hospitals to improve infection control activities.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Detection of Metallo-Beta-lactamase Production in Rare Carbapenem-Resistant Non-fermentative Gram-Negative Bacilli Isolated in a Tertiary Care Hospital, Visakhapatnam, India

Introduction: Non-fermentative Gram-negative bacilli (NFGNB) are occasionally involved in infectious diseases pathology, but have shown resistance to multiple antibiotics and the capability to gain new resistance factors in the hospital environment. The present study was aimed to investigate the antibiotic susceptibility pattern of rare NFGNB isolated from different clinical samples and the pre...

متن کامل

Detection of Carbapenemases Emerging in Acinetobacter baumannii Clinical Isolates by Modified Hodge Test

Introduction: Acinetobacter baumannii, a known causative agent of nosocomial infections, is one of the highly antibiotic-resistant gram-negative bacilli. Carbapenem-resistant Acinetobacter isolates are increasingly reported worldwide. Carbapenems such as imipenem and meropenem are efficient antimicrobial agents commonly used for the treatment of infections caused by multi- resistant A. baumanni...

متن کامل

Xpert CARBA-R Assay for the Detection of Carbapenemase-Producing Organisms in Intensive Care Unit Patients of a Korean Tertiary Care Hospital.

Carbapenemase-producing organisms (CPO) are rapidly disseminating worldwide, and their presence in tertiary care hospitals poses a significant threat to the management of nosocomial infections. There is a need to control CPO, especially in intensive care unit (ICU) patients, because these organisms are resistant to most β-lactam antibiotics and are easily transmitted. At present, the identifica...

متن کامل

Multisite Evaluation of Cepheid Xpert Carba-R Assay for Detection of Carbapenemase-Producing Organisms in Rectal Swabs

Rapid identification of patients who are colonized with carbapenemase-producing organisms (CPO) is included in multiple national guidelines for containment of these organisms. In a multisite study, we evaluated the performance of the Cepheid Xpert Carba-R assay, a qualitative diagnostic test that was designed for the rapid detection and differentiation of the blaKPC, blaNDM, blaVIM, blaOXA-48, ...

متن کامل

Prevalence and Antibiotic Resistance Pattern of Extended Spectrum β-Lactamase- (ESBL-) Producing Gram Negative Bacilli isolated from Clinical Samples of hospitalized Patients in a hospital in Gorgan

Background & Aim: Antibiotic resistance among gram-negative bacilli is currently one of the major challenges for the health system in developing countries. The aim of this study was to determine the frequency and antibiotic resistance pattern of common ESBL-producing gram negative bacilli isolated from clinical specimens of hospitalized patients in Falsafi Hospital in Gorgan. Methods: In this ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Journal of clinical microbiology

دوره 51 11  شماره 

صفحات  -

تاریخ انتشار 2013