Rapid Identification of Five Classes of Carbapenem Resistance Genes Directly from Rectal Swabs by Use of the Xpert Carba-R Assay

Journal of Clinical Microbiology
Nicholas M MooreCarba-R Study Team

Abstract

Carbapenemase-producing organisms (CPO) have been identified by global health leaders as an urgent threat. Detection of patients with gastrointestinal carriage of CPO is necessary to interrupt their spread within health care facilities. In this multisite study, we assessed the performance of the Xpert Carba-R test, a rapid real-time quantitative PCR (qPCR) assay that detects five families of carbapenemase genes (blaIMP,blaKPC,blaNDM,blaOXA-48, andblaVIM) directly from rectal swab specimens. Using dual swabs, specimens from 755 patients were collected and tested prospectively. An additional 432 contrived specimens were prepared by seeding well-characterized carbapenem-susceptible and -nonsusceptible strains into a rectal swab matrix and inoculating them onto swabs prior to testing. Antimicrobial susceptibility testing, broth enriched culture, and DNA sequencing were performed by a central laboratory blind to the Xpert Carba-R results. The Xpert Carba-R assay demonstrated a positive percentage of agreement (PPA) between 60 and 100% for four targets (blaKPC,blaNDM,blaVIM, andblaOXA-48) and a negative percentage of agreement (NPA) ranging between 98.9 and 99.9% relative to the reference method (culture and sequencing of any carbape...Continue Reading

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Citations

Jun 1, 2018·Journal of Clinical Microbiology·Maria M TraczewskiUNKNOWN Carba-R Study Team
Feb 13, 2018·Expert Review of Molecular Diagnostics·Molly E FleeceEric R Houpt
Dec 21, 2019·Annals of Laboratory Medicine·Jung Hyun ByunDongeun Yong
Apr 11, 2019·European Journal of Microbiology & Immunology·Hans KollendaMohamed Ben Moussa
Feb 13, 2021·Enfermedades infecciosas y microbiología clínica·Alba de la Rica-MartínezAntonio Galiana-Cabrera
May 1, 2021·Expert Review of Molecular Diagnostics·Michael R JacobsDaniel D Rhoads
Jun 12, 2021·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Rebecca YeePatricia J Simner

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