High-Stringency Evaluation of the Automated BD Phoenix CPO Detect and Rapidec Carba NP Tests for Detection and Classification of Carbapenemases

Thomson, Gina K.; Turner, David P. J.; Brasso, William B.; Kircher, Susan; Guillet, Thierry

doi:10.1128/jcm.01215-17

Cited by 34 publications

(40 citation statements)

References 28 publications

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“…Becton-Dickinson (BD, Sparks, USA) recently developed the Phoenix CPO Detect Test, a growth-based method embedded in Gram-negative (GN) panels for the detection and confirmation of carbapenemases of classes A, B and D [21]. This study aimed to determine the performance of the CPO test and to investigate its added value in routine diagnostic workflows.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the BD Phoenix™ CPO Detect Test for the detection of carbapenemase producers

Croxatto

Coste

Pillonel

et al. 2020

Clinical Microbiology and Infection

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Objectives: Becton-Dickinson recently developed the Phoenix™ CPO (carbapenemase-producing organism) Detect Test, a growth-based test embedded in Gram-negative (GN) panels for the detection and confirmation of bacteria producing class A, B and D carbapenemases. This study aimed to (a) determine the performance of the CPO test, and (b) assess its added value in routine diagnostic workflows. Methods: The performance of the BD Phoenix CPO test was analysed retrospectively on a collection of 185 molecularly characterized strains, including 92 CPOs, and prospectively on 135 and 160 routine isolates with and without CPO suspicion, respectively. Results: In the retrospective study the CPO test exhibited 92.4% accuracy (95%CI 87.6e95.8), 97.8% sensitivity (95%CI 92.4e99.7) and 87.1% specificity (95%CI 78.6e93.2) for carbapenemase detection. The CPO test provided a classification to class A, B, and D for 81.3% of detected carbapenemases with 94.6% accuracy (95%CI 86.7e98.5). In the prospective study the CPO test detection performance showed 77.8% accuracy (95%CI 68.8e84.5), 100% sensitivity (95%CI 91.2e100) and 67.8% specificity (95%CI 57.3e77.1) with 135 CPO-suspicious isolates and 98.8% accuracy and specificity (95%CI 95.6e99.9) with 160 non-CPO-suspicious isolates. Compared to routine testing, the implementation of the CPO test allowed a mean reduction of 21.3 h (95%CI 17.6e25) in turnaround time, 16.8 min (95%CI 13.4e20.2) in hands-on time, and 20.6 CHF (95%CI 16.5e24.8) in costs. Conclusions: The CPO test is reliable for the detection of CPO with a high sensitivity. However, the relatively low detection specificity required the use of additional confirmatory methods. The carbapenemase classification accuracy is robust in providing preliminary results before molecular characterization. Finally, the implementation of the test in routine workflows allowed a significant reduction in turnaround time, hands-on time and cost compared to the conventional approach.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the BD Phoenix™ CPO Detect Test for the detection of carbapenemase producers

Croxatto

Coste

Pillonel

et al. 2020

Clinical Microbiology and Infection

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“…The rapid spread of CPE, including those with MBLs, has become a critical challenge of infection control and treatment [8]. The first carbapenemaseproducing bacteria were identified in 1991 in Japan [9]. Since then, these beta-lactamases have spread worldwide among Gram-negative bacteria, especially K. pneumoniae strains.…”

Section: Discussionmentioning

confidence: 99%

“…The BD Phoenix CPO Detect is an automated system applying dedicated panels to detect and classify carbapenemases [9]. Using these panels, Thomson [23].…”

Section: Discussionmentioning

confidence: 99%

“…et al[9] identified 72.4 % of the isolates belonging to class B and 88.6 % to class D. In turn, Simon et al[22] obtained 100 % sensitivity and 79 % specificity while Ong et al[21] reported 90.6 % sensitivity and 100% specificity. Simon et al[22] demonstrated that the combination of the CPO Detect assay with the β-CARBA test allows for rapid detection and classification of carbapenemase-producing strains.…”

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Evaluation of the usefulness of selected methods for the detection of carbapenemases in Klebsiella strains

Sękowska

Bogiel

Kaczmarek

2020

Journal of Medical Microbiology

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Introduction. Klebsiella rods, belonging to the family Enterobacteriaceae , are generally opportunistic pathogens commonly associated with nosocomial infections, especially in intensive care units. Interestingly, strains of this genus also show multi-drug resistance. In recent years, multiple studies have indicated that the prevalence of carbapenem resistance has increased rapidly among Klebsiella representatives. Aim. The aim of this study was to assess the usefulness of selected phenotypic and genotypic methods for the detection of the most important carbapenemases in Klebsiella strains. Methodology. The study involved 51 Klebsiella strains. The ability to produce carbapenemases was determined by phenotypic methods (double disc synergy test, test with four discs and three inhibitors, CarbaNP test, culture on chromogenic medium, panels of automatic method – Phoenix, CIM test and modified Hodge test). The potential for carbapenemase synthesis was also evaluated using real-time PCR, detecting bla VIM/IMP, bla KPC, bla NDM and bla OXA-48 genes. Results. Using the phenotypic methods, positive results were obtained for all of the analysed strains. Using PCR, carbapenemase synthesis potential was confirmed on the molecular level; the bla VIM gene was detected in 23 strains, the bla NDM gene in 26 strains and the bla OXA-48 gene in two strains. Conclusion. There was complete agreement between the carbapenemases detected by the genetic method and the results obtained with phenotypic methods.

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“…Identification of class A carbapenemases indicates that the currently FDA-approved agents, ceftazidime/avibactam and meropenem/vaborbactam, are potential therapeutic options, while the detection of a class B carbapenemase contraindicates these agents. Classification can be a clinically powerful source of information about whether or not these agents are contenders for therapy but it does not eliminate the need for antibiotic susceptibility testing (15).…”

Section: Discussionmentioning

confidence: 99%

CPO Complete, a novel test for fast, accurate phenotypic detection and classification of carbapenemases

Thomson

AbdelGhani

2019

Preprint

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24Rapid, accurate detection of carbapenemase-producing organisms (CPOs) and 25 the classification of their carbapenemases are valuable tools for reducing the mortality 26 of the CPO-associated infections, preventing the spread of CPOs, and optimizing use of 27 new β-lactamase inhibitor combinations such as ceftazidime/avibactam and 28 meropenem/vaborbactam. The current study evaluated the performance of CPO29 Complete, a novel, manual, phenotypic carbapenemase detection and classification 30 test. The test was evaluated for sensitivity and specificity against 262 CPO isolates of 31 Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii and 67 32 non-CPO isolates. It was also evaluated for carbapenemase classification accuracy 33 against 205 CPOs that produced a single carbapenemase class. The test exhibited 34 100% sensitivity 98.5% specificity for carbapenemase detection within 90 minutes and 35 detected 74.1% of carbapenemases within 10 minutes. In the classification evaluation, 36 99.0% of carbapenemases were correctly classified. The test is technically simple and 37 has potential for adaptation to automated instruments. With lyophilized kit storage at 38 temperatures up to 38 o C the CPO Complete test has the potential to provide rapid, 39 accurate carbapenemase detection and classification in both limited resource and 40 technologically advanced laboratories.41 3 42 Background 43 Infections by carbapenemase-producing organisms (CPOs) are associated with 44 high mortality (1-4). The main contributors to this are the extensive, sometimes total, 45 antibiotic resistance of CPOs, failures to provide effective therapy, and inadequate 46 infection control. Rapid CPO detection and carbapenemase classification can be pivotal 47 to efforts to reduce the mortality. Speed of detection is critical for effective infection 48 control and for prompt initiation of combination antibiotic therapy, which is optimal for 49 serious CPO infections (2, 3, 5-16). Classification of carbapenemases can optimize 50 appropriate use of new β-lactamase inhibitor combinations such as 51 ceftazidime/avibactam, meropenem/vaborbactam, imipenem/relebactam, 52 aztreonam/avibactam, meropenem/nacubactam, cefepime/zidebactam and 53 cefepime/VNRX-5133 and minimize their overuse. Currently marketed rapid, phenotypic 54 manual CPO tests do not classify carbapenemases. 55The CPO Complete test is a manual CPO detection and classification test 56 designed to provide rapid, accurate results. The current study was designed to assess 57 its speed and accuracy of CPO detection and its potential to classify carbapenemases. 58 59 Materials and Methods 60 Isolates Three hundred twenty nine isolates of Enterobacteriaceae, Pseudomonas 61 aeruginosa and Acinetobacter baumannii from two culture collections, that of the 62 University of Louisville and also the Antimicrobial Resistance Isolate Bank of the 63 Centers for Disease Control and Prevention and Food and Drug Administration, were 4 64 characterized for types of β-lactamase production by ...

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High-Stringency Evaluation of the Automated BD Phoenix CPO Detect and Rapidec Carba NP Tests for Detection and Classification of Carbapenemases

Cited by 34 publications

References 28 publications

Evaluation of the BD Phoenix™ CPO Detect Test for the detection of carbapenemase producers

Evaluation of the BD Phoenix™ CPO Detect Test for the detection of carbapenemase producers

Evaluation of the usefulness of selected methods for the detection of carbapenemases in Klebsiella strains

CPO Complete, a novel test for fast, accurate phenotypic detection and classification of carbapenemases

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