Evaluation of Rapid Immunochromatographic Tests for the Direct Detection of Extended Spectrum Beta-Lactamases and Carbapenemases in Enterobacterales Isolated from Positive Blood Cultures

Keshta, Ahmed S; Elamin, Nazik; Hasan, Mohammad Rubayet; Pérez-López, Andrés; Roscoe, Diane; Tang, Patrick; Suleiman, Mohammed

doi:10.1128/spectrum.00785-21

Cited by 10 publications

(6 citation statements)

References 10 publications

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“…At present, some phenotypic-based identification methods, such as biochemical identification and bacterial identification system, are used to detect K. pneumoniae ( 7 , 8 ). Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) was also commonly used to identify K. pneumoniae ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

One-Pot Isothermal LAMP-CRISPR-Based Assay for Klebsiella pneumoniae Detection

Qiu

Liu

et al. 2022

Microbiol Spectr

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Section: Introductionmentioning

confidence: 99%

One-Pot Isothermal LAMP-CRISPR-Based Assay for Klebsiella pneumoniae Detection

Qiu

Liu

et al. 2022

Microbiol Spectr

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“…Furthermore, the CTX-M LFA had higher sensitivity than the ESBL NP test, while both tests had very high specificities. By comparison, the CTX-M LFA had a 91.6-100% sensitivity and a 95.0-100% specificity for direct testing of positive blood culture broths [13,14,[22][23][24][25][26][27]. In earlier study that used the CTX-M LFA to test positive clinical blood culture broths, the sensitivity and specificity were 100% (95% CI, 96.0-100%) and 99.6% (97.9-100%), respectively [14].…”

Section: Discussionmentioning

confidence: 97%

Evaluation of Two Tests for the Rapid Detection of CTX-M Producers Directly in Urine Samples

Tang,

Lee,

et al. 2023

Antibiotics

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Infections caused by extended-spectrum β-lactamase-producing Enterobacterales have increased rapidly and are mainly attributed to the production of CTX-M enzymes. This study evaluated the NG-Test® CTX-M MULTI lateral flow assay (CTX-M LFA) and the Rapid ESBL NP® test (ESBL NP test) for rapid detection of CTX-M-producing Enterobacterales directly in midstream urine (MSU) samples. Testing was performed on 277 clinical MSU samples in a hospital microbiology laboratory from November 2022 to January 2023; 60 of these samples (30 positive for ESBL producers and 30 positive for non-ESBL producers) were tested retrospectively after the identification and susceptibility results were obtained, and 217 samples were tested prospectively immediately after a Gram stain showing the presence of Gram-negative bacilli. The results were compared against phenotypic detection of ESBL and molecular testing as the reference methods. Overall, 67 of the 277 samples were culture-positive for ESBL-producing Enterobacterales. PCR for the blaCTX-M gene was positive for all ESBL-producing Enterobacterales isolates. All CTX-M LFA results were interpretable, while three of the ESBL NP test results were noninterpretable. The sensitivity of the CTX-M LFA (100%, 95% CI 94.6–100%) was higher than that of the ESBL NP test (86.6%, 95% CI 76.0–93.7%). Both tests had high specificities (CTX-M LFA, 99.1%, 95% CI 96.6–99.9% and ESBL NP test, 100%, 95% CI 98.2–100%). In conclusion, both the CTX-M LFA and the ESBL NP test can deliver rapid results that could improve antimicrobial stewardship for urinary tract infections.

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“…In our pilot testing, we found that false-negative or weak positive results may occur with some CTX-M producers in BC broths and that the issue can be resolved by adding this incubation step. In all previous studies that evaluate CTX-M LFA, testing was performed on cell pellets obtained from BC broths, thus involving centrifugation, removal of supernatant and resuspension [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Furthermore, most previous studies performed CTX-M LFA after bacterial identification was obtained using the cell pellet from BC broth ( Table 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…The NG-Test CTX-M MULTI (CTX-M LFA) test (NG-Biotech Laboratories, France) is a lateral flow assay that is able to detect CTX-M producers rapidly in positive blood culture (BC) fluids [ 7 ]. However, most of the previous studies on direct detection of CTX-M producers from positive BCs were carried out after bacterial identification confirmed the presence of Enterobacterales and only a few species were tested [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. This study aimed to assess the diagnostic performance of the NG-CTX-M Test for direct detection of CTX-M producers in BCs positive for Gram-negative bacilli (GNB) before definitive identification.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Lateral Flow Immunoassay for Rapid Detection of CTX-M Producers from Blood Cultures

et al. 2023

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Bacteremia caused by extended-spectrum β-lactamases-producing Enterobacterales has increased rapidly and is mainly attributed to CTX-M enzymes. This study aimed to evaluate the NG-Test® CTX-M MULTI lateral flow assay (CTX-M LFA) for rapid detection of CTX-M producers in blood cultures (BCs) positive for Gram-negative bacilli in spiked and clinical BCs. Retrospective testing was performed on BC bottles spiked with a collection of well-characterized Enterobacterales isolates producing CTX-M (n = 15) and CTX-M-like (n = 27) β-lactamases. Prospective testing of clinical, non-duplicate BCs (n = 350) was performed in two hospital microbiology laboratories from April 2021 to March 2022 following detection of Gram-negative bacilli by microscopic examination. Results were compared against molecular testing as the reference. In the spiked BCs, the CTX-M LFA correctly detected all CTX-M producers including 5 isolates with hybrid CTX-M variants. However, false-positive results were observed for several CTX-M-like β-lactamases, including OXY-1-3, OXY-2-8, OXY-5-3, FONA-8, -9, -10, 11, 13 and SFO-1. In clinical BCs, the CTX-M LFA showed 100% (95% CI, 96.0–100%) sensitivity and 99.6% (97.9–100%) specificity. In conclusion, this study showed that rapid detection of CTX-M producers in BC broths can be reliably achieved using the CTX-M LFA, thus providing an opportunity for early optimization of antibiotics.

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Evaluation of Rapid Immunochromatographic Tests for the Direct Detection of Extended Spectrum Beta-Lactamases and Carbapenemases in Enterobacterales Isolated from Positive Blood Cultures

Cited by 10 publications

References 10 publications

One-Pot Isothermal LAMP-CRISPR-Based Assay for Klebsiella pneumoniae Detection

One-Pot Isothermal LAMP-CRISPR-Based Assay for Klebsiella pneumoniae Detection

Evaluation of Two Tests for the Rapid Detection of CTX-M Producers Directly in Urine Samples

Evaluation of a Lateral Flow Immunoassay for Rapid Detection of CTX-M Producers from Blood Cultures

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