Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae.

September 8, 2015 at 3:55 pm

Emerg Infect Dis. 2015 Sep;21(9):1611-6.

Chea N, Bulens SN, Kongphet-Tran T, Lynfield R, Shaw KM, Vagnone PS, Kainer MA, Muleta DB, Wilson L, Vaeth E, Dumyati G, Concannon C, Phipps EC, Culbreath K, Janelle SJ, Bamberg WM, Guh AY, Limbago B, Kallen AJ.

Preventing transmission of carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE) is a public health priority.

A phenotype-based definition that reliably identifies CP-CRE while minimizing misclassification of non-CP-CRE could help prevention efforts.

To assess possible definitions, we evaluated enterobacterial isolates that had been tested and deemed nonsusceptible to >1 carbapenem at US Emerging Infections Program sites.

We determined the number of non-CP isolates that met (false positives) and CP isolates that did not meet (false negatives) the Centers for Disease Control and Prevention CRE definition in use during our study: 30% (94/312) of CRE had carbapenemase genes, and 21% (14/67) of Klebsiella pneumoniae carbapenemase-producing Klebsiella isolates had been misclassified as non-CP.

A new definition requiring resistance to 1 carbapenem rarely missed CP strains, but 55% of results were false positive; adding the modified Hodge test to the definition decreased false positives to 12%.

This definition should be considered for use in carbapenemase-producing CRE surveillance and prevention.

PDF

http://wwwnc.cdc.gov/eid/article/21/9/pdfs/15-0198.pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Biología Molecular, Epidemiología, Health Care-Associated Infections, Infecciones nosocomiales, Metodos diagnosticos, Resistencia bacteriana, Sepsis. Tags: .

First report of emergence of OXA-48 carbapenemase-producing Enterobacteriaceae in Singapore: proactive or reactive infection control strategy? Pressure ulcer-related pelvic osteomyelitis: A neglected disease?


Calendar

September 2015
M T W T F S S
« Aug   Oct »
 123456
78910111213
14151617181920
21222324252627
282930  

Most Recent Posts


%d bloggers like this: