Carbapenem-resistant Enterobacteriaceae (CRE) detection practices in California: What are we missing?

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Romney M HumphriesJames A McKinnell

Abstract

The Clinical and Laboratory Standards Institute (CLSI) revised carbapenem breakpoints for the Enterobacteriaceae in 2010. The number of hospitals that adopted revised CLSI breakpoints and the clinical impact of delayed adoption has not been previously explored. We performed a cross-sectional, voluntary survey of microbiology laboratories that serve California acute care hospitals and long-term acute care hospitals (LTAC) to determine use of revised CLSI breakpoints. CRE clinical isolates from a single tertiary care hospital from 2013 to 2017 were examined. All isolates with an elevated minimum inhibitory concentration (MIC) (≥ 2 µg/mL) to imipenem or meropenem were tested for the presence of a carbapenemase gene by PCR. We received responses from 128 laboratories that serve 264/393 (67%) of hospitals and LTACs. Current CLSI carbapenem breakpoints for Enterobacteriaceae were used by 92/128 (72%) laboratories. Among laboratories using current breakpoints, time to implementation varied from 0 - 68 months (mean, 41 months, median, 55 months). Application of historical breakpoints to isolates in with a carbapenemase gene detected by PCR resulted in susceptibility rates of 8.9%, 18.6%, and 18.6% to ertapenem, imipenem, and meropenem,...Continue Reading

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Citations

Jan 26, 2018·Journal of Clinical Microbiology·Romney M HumphriesUNKNOWN CLSI Methods Development and Standardization Working Group of the Subcommittee on Antimicrobial Susceptibility Testing
Mar 5, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Margaret A FitzpatrickUNKNOWN QUERI CARRIAGE Program
Apr 12, 2019·Journal of Clinical Microbiology·Romney M HumphriesJanet A Hindler
Apr 19, 2019·Journal of Clinical Microbiology·Romney M Humphries
Nov 5, 2019·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Melanie L YarbroughCarey-Ann D Burnham
May 26, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Romney M HumphriesAmy Mathers
May 3, 2019·Journal of Clinical Microbiology·Tam T VanSusan M Butler-Wu
Dec 3, 2020·International Journal of Antimicrobial Agents·Nan-Yao LeeWen-Chien Ko

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