Rapid detection of carbapenemase-producing organisms directly from blood cultures positive for Gram-negative bacilli

Stokes, William; Pitout, Johann; Campbell, Lorraine; Church, Deirdre L.; Gregson, Daniel B.

doi:10.1007/s10096-020-04005-4

Cited by 5 publications

(1 citation statement)

References 17 publications

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“…Several phenotypic and genotypic tests are available for direct detection of carbapenemase from positive blood culture, e.g., colorimetric methods such as β CARBA® and NeoRapid CARB, which are limited by decreased specificity of the tests. Immunochromatographic test as NG-Test® CARBA 5. and molecular assays, e.g., Xpert® Carba-R, are helpful, but they detect only the five common carbapenemases [13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Detection of carbapenemase production by blood culture carbapenem inactivation method (bcCIM) compared to modified carbapenem inactivation method (mCIM) in bloodstream infections

Abdallah

2021

Egyptian Journal of Medical Microbiology

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Background: Early detection of bloodstream infections (BSIs) caused by carbapenemase-producing organisms can guide rapid lifesaving appropriate therapy.A new variant of the modified Carbapenem Inactivation Method (mCIM) test, named blood culture CIM (bcCIM), can directly detect carbapenemase enzymes from positive blood culture. Objective: This study aimed at comparing detection of carbapenemase activity in Gram-negative bacilli (GNB) by Carbapenem Inactivation Method on positive blood culture and isolated colonies. Methodology: bcCIM test was used to detect carbapenemase production in 38 positive blood cultures. Subculture of blood samples followed by isolation and identification of causative pathogens was done, antimicrobial susceptibility by disk diffusion test as well as performing mCIM test were applied to all isolated GNB. Results: Forty-one GNB were isolated. Klebsiella spp. was the most common isolated GNB 16 (39%). Most isolated GNB were carbapenemresistant 31(75.6%). For monomicrobial bloodstream infection, there was fair (kappa =0.327), moderate (kappa=0.429), and slight agreement (kappa=0.158) between results of mCIM and results of bcCIM as regards all GNB, Enterobacteriaceae, and Pseudomonas, respectively. Conclusion: bcCIM is a promising test for direct detection of carbapenemase activity, particularly in carbapenem-resistant Enterobacteriaceae. Further studies are needed for the standardization of this method.

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Section: Introductionmentioning

confidence: 99%

Detection of carbapenemase production by blood culture carbapenem inactivation method (bcCIM) compared to modified carbapenem inactivation method (mCIM) in bloodstream infections

Abdallah

2021

Egyptian Journal of Medical Microbiology

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Concordance of the filmarray blood culture identification panel 2 and classical microbiological methods in a bacteriemia diagnostic unit

García-Rivera

Parra-Grande

Merino

et al. 2022

Diagnostic Microbiology and Infectious Disease

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Evaluation of a diagnostic algorithm for rapid identification of Gram-negative species and detection of extended-spectrum β-lactamase and carbapenemase directly from blood cultures

Comini

Bianco

Boattini

et al. 2022

Journal of Antimicrobial Chemotherapy

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Objectives To evaluate a rapid diagnostic algorithm based on MALDI-TOF MS, lateral flow immunoassays (LFIAs) and molecular testing performed directly from positive blood cultures (BCs) for Gram-negative species identification and detection of CTX-M extended-spectrum β-lactamases and main carbapenemases. Methods Non-duplicate BCs positive to Gram-negative bacteria at microscope examination were subjected to species identification by direct MALDI-TOF MS following recovery of bacterial pellet by Rapid MBT Sepsityper® kit. Subsequently, NG-Test® CARBA 5 and NG-Test® CTX-M MULTI LFIAs were performed according to identified microbial species. Eazyplex® SuperBug CRE molecular assay was performed in cases of NG-Test® CARBA 5 negative results in patients with documented carbapenemase-producers carriage. Results of rapid diagnostic workflow were compared with those obtained by conventional diagnostic routine. Results Overall, the direct MALDI-TOF MS protocol allowed reliable identification to the species level of 92.1% of the 2133 monomicrobial BCs. Rate of matched identification was significantly higher for Enterobacterales (97.3%) in comparison to non-fermenting Gram-negative species (80.2%), obligate anaerobic bacteria (42.1%) and fastidious Gram-negative species (41.5%). The overall sensitivity of NG-Test® CARBA 5 and NG-Test® CTX-M MULTI was 92.2% and 91.6%, respectively. Integration of Easyplex® SuperBug CRE allowed the detection of blaKPC mutants associated with ceftazidime/avibactam resistance, reaching 100% sensitivity in carbapenemase detection. Both LFIAs and molecular testing showed no false-positive results. Conclusions Algorithms based on MALDI-TOF MS, LFIAs and molecular testing may represent a cost-effective tool to timely identify Gram-negative species and detect resistance markers directly from BCs. According to local epidemiology, these results may allow antimicrobial stewardship interventions including prompt use of new approved drugs.

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Rapid detection of carbapenemase-producing organisms directly from blood cultures positive for Gram-negative bacilli

Cited by 5 publications

References 17 publications

Detection of carbapenemase production by blood culture carbapenem inactivation method (bcCIM) compared to modified carbapenem inactivation method (mCIM) in bloodstream infections

Detection of carbapenemase production by blood culture carbapenem inactivation method (bcCIM) compared to modified carbapenem inactivation method (mCIM) in bloodstream infections

Concordance of the filmarray blood culture identification panel 2 and classical microbiological methods in a bacteriemia diagnostic unit

Evaluation of a diagnostic algorithm for rapid identification of Gram-negative species and detection of extended-spectrum β-lactamase and carbapenemase directly from blood cultures

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