Details

Autor(en) / Beteiligte

• Pham, Thi Anh Mai
• Nguyen, Tung Xuan
• My, Troung Nhat
• Le, Lan Thi
• Vu, Huyen Thi
• Hoang, Ngoc Thi Bich
• Tran, Dien M
• Nguyen, Linh Viet
• Pham, Phuc D
• Nurjadi, Dennis
• Goutard, Flavie
• Velavan, Thirumalaisamy P
• Dinh, Van Anh Thi
• Hounmanou, Y M Gildas
• Jörgensen, Bent
• Song, Le Huu
• Nguyen, Nhung T T
• Loire, Etienne
• Östholm, Åse
• Nilsson, Lennart E
• Tran, Tuyet Hanh T
• Phan, Phuc H
• Dalsgaard, Anders
• Larsson, Mattias
• Olson, Linus
• Hanberger, Håkan

Titel

Evaluation of screening algorithms to detect rectal colonization with carbapenemase-producing Enterobacterales in a resource-limited setting

Ist Teil von

• JAC-antimicrobial resistance, 2024-06, Vol.6 (3), p.dlae089

Ort / Verlag

UK: Oxford University Press

Erscheinungsjahr

2024

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Abstract Objectives To improve and rationalize the detection of carbapenemase-producing Enterobacterales (CPE) in rectal swabs in a high-prevalence and resource-constrained setting, addressing surveillance challenges typically encountered in laboratories with limited resources. Methods A point prevalence survey (PPS) was conducted on 15 August 2022, in a provincial children’s hospital in northern Vietnam. Rectal swab samples of all admitted children were collected and plated on a selective medium for carbapenem-resistant Enterobacterales (CRE). Species identification and antimicrobial susceptibility testing (AST) were performed by MALDI-TOF, and VITEK2 XL and interpreted according to CLSI breakpoints (2022). Carbapenemases were detected by the carbapenem inactivation method (CIM) and quantitative real-time PCR (qRT-PCR). Results Rectal swab samples were obtained from 376 patients. Of 178 isolates growing on the CRE screening agar, 140 isolates were confirmed as Enterobacterales of which 118 (84.3%) isolates were resistant to meropenem and/or ertapenem. CIM and PCR showed that 90/118 (76.3%) were carbapenemase producers. Overall, 83/367 (22.6%) were colonized by CPE. Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae complex were the most common CPE detected, with NDM as the predominant carbapenemase (78/90; 86.7%). Phenotypic resistance to meropenem was the best predictor of CPE production (sensitivity 85.6%, specificity 100%) compared with ertapenem resistance (95.6% sensitivity, 36% specificity). CIM was 100% concordant with PCR in detecting carbapenemases. Conclusions These findings underscore the effectiveness of meropenem resistance as a robust indicator of the production of carbapenemases and the reliability of the CIM method to detect such carbapenemases in resource-limited settings where the performance of molecular methods is not possible.