Clinical Performance of Check-Direct CPE, a Multiplex PCR for Direct Detection of bla(KPC), bla(NDM) and/or bla(VIM), and bla(OXA)-48 from Perirectal Swabs

Journal of Clinical Microbiology
Anna F LauKaren M Frank

Abstract

We evaluated the clinical performance of Check-Direct CPE for carbapenemase detection directly from 301 perirectal swabs (258 patients) in a nonoutbreak setting. Culture of a PCR-confirmed, carbapenemase-containing organism, or history of colonization with such organism within the previous 2 weeks, was used as the reference standard. Check-Direct CPE demonstrated a sensitivity value, specificity value, positive predictive value (PPV), and negative predictive value (NPV) of 100% (all bla(KPC)), 88%, 21%, and 100%, respectively. False positives accounted for 79% (n = 34) of samples for which a cycle threshold (C(T)) value was reached. Simulated studies to evaluate specimen pooling as an approach to minimize costs showed no difference in C(T) values for pooled groups of three or five that each contained a single specimen spiked with ∼1,500 CFU bla(KPC) Klebsiella pneumoniae; however, the detection rate dropped to 60% at a seeded concentration of ∼150 CFU. When data were pooled, C(T) values for bla(KPC) were higher for heavy-feces-containing than for light-feces-containing liquid-suspended specimens. Furthermore, C(T) values for liquid-suspended specimens were 4 to 5 C(T) values lower (i.e., represented greater sensitivity) than th...Continue Reading

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Citations

Aug 16, 2016·The Journal of Antimicrobial Chemotherapy·Jonathan A OtterSimon D Goldenberg
May 19, 2017·Journal of Clinical Microbiology·Nicholas M MooreUNKNOWN Carba-R Study Team
Oct 16, 2015·Journal of Clinical Microbiology·Romney M Humphries, James A McKinnell
Nov 15, 2019·Clinical Microbiology Reviews·Johann D D PitoutYasufumi Matsumura
Oct 27, 2016·Current Opinion in Infectious Diseases·Gökhan Metan, Murat Akova
Dec 21, 2019·Annals of Laboratory Medicine·Jung Hyun ByunDongeun Yong
May 21, 2020·Microbial Drug Resistance : MDR : Mechanisms, Epidemiology, and Disease·Delphine GirlichThierry Naas
May 11, 2021·Frontiers in Cellular and Infection Microbiology·Hsin-Yu ChenPo-Ren Hsueh
Oct 5, 2020·Infectious Disease Clinics of North America·Andrea EndimianiMichael R Jacobs

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