دورية أكاديمية

2142. Comparison of Molecular-Based vs. Conventional Culture-Based Screening Methods for Detection of Carriers of Extended-Spectrum β-Lactamases (ESBL) and Carbapenemases-Producing Enterobacteriacae (CPE)

التفاصيل البيبلوغرافية
العنوان: 2142. Comparison of Molecular-Based vs. Conventional Culture-Based Screening Methods for Detection of Carriers of Extended-Spectrum β-Lactamases (ESBL) and Carbapenemases-Producing Enterobacteriacae (CPE)
المؤلفون: Martischang, Romain, Renzi, Gesuele, François, Patrice, Bonetti, Eve-Julie, Cherkaoui, Abdessalam, Pugin, Jérôme, Schrenzel, Jacques, Harbarth, Stephan
المصدر: Open Forum Infectious Diseases ; volume 6, issue Supplement_2, page S726-S726 ; ISSN 2328-8957
بيانات النشر: Oxford University Press (OUP)
سنة النشر: 2019
مصطلحات موضوعية: Infectious Diseases, Oncology
الوصف: Background Active surveillance and contact precautions may prevent cross-transmission of ESBL-producing Enterobacteriaceae and CPE. Culture-based methods delaying results might increase risk of cross-transmission, and lead to unnecessary preemptive contact precautions. This observational cohort study compared rapid Loop-Mediated Isothermal Amplification (LAMP) assays to conventional culture-based methods for ESBL and CPE screening of critically ill patients. Methods This study was conducted in the adult ICUs at Geneva University Hospitals. We collected consecutive rectal ESwabs routinely performed, either for admission screening of high-risk patients or once weekly routine screening of all patients hospitalized in the ICU. Eazyplex® SuperBug CRE system (Amplex Biosystems) assays were performed directly on rectal Eswabs according to the manufacturer’s instructions. For the conventional culture-based method, we used chromID® ESBL agar (ESBL) coupled with chromID®OXA-48. Discordant specimens were retested using disk diffusion tests and the same LAMP assay on isolates. Microbiological turn-around times (TAT; from the reception in the laboratory to result notification) were collected. Results Overall, 290 rectal ESwabs were analyzed. ESBL and CPE prevalence were 16.7% and 1.0%, respectively. Three discordant isolates could not be further investigated and considered as LAMP false positive. Adjusted analytical performances were for CPE: 100% (95IC 100–100%) sensitivity, 99.6% (99.0–100%) specificity, 75% (32.6–100%) PPV, and 100% (100–100%) NPV, and for ESBL: 85% (73.9–96.1%) sensitivity, 98.8% (97.4–100%) specificity, 91.9% (83.1–100%) PPV, and 97.6% (95.7–99.5%) NPV. A decrease in TAT was observed when comparing LAMP screening assay against conventional method (50.3 hours vs. 6.2 hours; Figure 1). Figure 2 shows time reductions comparing both screening strategies. Conclusion Screening strategies based on LAMP could fasten discontinuation of unnecessary pre-emptive isolation time for patients at risk and ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1093/ofid/ofz360.1822
الإتاحة: https://doi.org/10.1093/ofid/ofz360.1822Test
http://academic.oup.com/ofid/article-pdf/6/Supplement_2/S726/30275265/ofz360.1822.pdfTest
حقوق: http://creativecommons.org/licenses/by-nc-nd/4.0Test/
رقم الانضمام: edsbas.FF43E013
قاعدة البيانات: BASE