Combined selective culture and molecular methods for the detection of carbapenem-resistant organisms from fecal specimens.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
Rebecca YeePatricia J Simner

Abstract

Detection of patients with intestinal colonization of carbapenem-resistant organisms (CRO), or more specifically carbapenemase-producing (CP) CRO, can prevent their transmission in healthcare facilities and aid with outbreak investigations. The objective of this work was to further develop and compare methods that combine selective culture and/or PCR to rapidly detect and recover CRO from fecal specimens. Molecularly characterized Gram-negative bacilli (n = 62) were used to spike fecal samples to establish limit of detection (LOD; n = 12), sensitivity (n = 28), and specificity (n= 21) for 3 methods to detect CP-CRO: direct MacConkey (MAC) plate and Xpert Carba-R (Cepheid) on growth, MAC broth and Carba-R testing of the broth, and direct testing by Carba-R. This was followed by a clinical study comparing methods in parallel for 286 fecal specimens. The LOD ranged from 102-105 CFU/mL depending on the carbapenemase gene and method. Combined culture/PCR methods had a sensitivity of 100%, whereas direct Carba-R testing had a sensitivity of 96% for the detection of CP-CRO. All methods had specificities of 100%. The prevalence of CP-CRO (0.7%) and non-CP-CRO (5.2 %) were low in the clinical study, where all methods demonstrated 100% a...Continue Reading

References

Oct 30, 2015·Clinical Microbiology Reviews·Roberto ViauRobert A Bonomo
May 19, 2017·Journal of Clinical Microbiology·Nicholas M MooreUNKNOWN Carba-R Study Team
Dec 16, 2017·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Ester SolterMitchell J Schwaber
May 30, 2019·Antimicrobial Agents and Chemotherapy·Pranita D TammaPatricia J Simner
Feb 28, 2020·Clinical Microbiology Reviews·Karen Bush, Patricia A Bradford

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