Evaluation of SuperCAZ/AVI® Medium for Screening Ceftazidime-avibactam Resistant Gram-negative Isolates

Sadek, Mustafa; Poirel, Laurent; Pino, Manuel Dominguez; D'Emidio, Fernando; Pomponio, Stefano; Nordmann, Patrice

doi:10.1016/j.diagmicrobio.2021.115475

Cited by 2 publications

(4 citation statements)

References 20 publications

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“…To our knowledge, this is the first study evaluating the implementation of a selective medium for real-life screening of CAZ-AVI-resistant bacteria on rectal swabs. The excellent diagnostic sensitivity (100%) of Chromatic Super CAZ/AVI ® medium, which was preliminarily shown in studies involving full molecularly characterized bacterial strains [8,9], has been confirmed in our active surveillance. Although specificity was 86.6%, lower than those previously reported [8,9], integration of the Chromatic Super CAZ/AVI ® medium into surveillance culture diagnostic protocols for carbapenemase-resistant organisms could contribute to control dissemination of CAZ-AVI-resistant strains by rapid implementation of infection control measures.…”

Section: Discussionsupporting

confidence: 69%

“…The excellent diagnostic sensitivity (100%) of Chromatic Super CAZ/AVI ® medium, which was preliminarily shown in studies involving full molecularly characterized bacterial strains [8,9], has been confirmed in our active surveillance. Although specificity was 86.6%, lower than those previously reported [8,9], integration of the Chromatic Super CAZ/AVI ® medium into surveillance culture diagnostic protocols for carbapenemase-resistant organisms could contribute to control dissemination of CAZ-AVI-resistant strains by rapid implementation of infection control measures. Furthermore, its use could be essential to detect CAZ-AVI-resistant Enterobacterales strains expressing KPC variants with weak carbapenemase activity.…”

Section: Discussionsupporting

confidence: 69%

“…Recently, a selective culture medium, namely the Chromatic Super CAZ/AVI ® medium (Liofilchem, Roseto degli Abruzzi, Italy), was developed and evaluated for screening CAZ-AVI resistance among Gram-negative bacteria including molecularly characterized Enterobacterales and P. aeruginosa strains [ 8 , 9 ]. The medium showed a sensitivity and specificity of 100% in detection of CAZ-AVI-resistant strains regardless of their resistance mechanisms.…”

Section: Introductionmentioning

confidence: 99%

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Implementation of Chromatic Super CAZ/AVI® medium for active surveillance of ceftazidime-avibactam resistance: preventing the loop from becoming a spiral

Bianco

Boattini

Comini

et al. 2022

Eur J Clin Microbiol Infect Dis

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Acquired resistance towards ceftazidime-avibactam (CAZ-AVI) is increasingly reported. Several mechanisms can be involved, but mutations in the Ω-loop region of β-lactamases are the most described. Herein, we assessed the implementation of Chromatic Super CAZ/AVI® medium in rectal swab surveillance cultures in a geographic area with endemic distribution of KPC-producing Klebsiella pneumoniae. Routine rectal swabs collected from the intensive care unit (ICU) and non-ICU patients were screened for carbapenemase-producing Enterobacterales (CPE), carbapenem-resistant Gram-negative organisms (CR-GN) and CAZ-AVI-resistant organisms by Chromatic CRE and Super CAZ/AVI® media. Among the 1839 patients screened, 146 (7.9%) were found to be colonized by one or more CPE and/or CR-GN isolates during hospitalization. Overall, among colonized patients the most common bacteria encountered were KPC-producing Enterobacterales (n = 60; 41.1%), carbapenem-resistant Pseudomonas aeruginosa (n = 41; 28.1%) and carbapenem-resistant A. baumannii (n = 34; 23.3%). Among patients colonized by KPC-producing Enterobacterales, thirty-five (58.3%) had CAZ-AVI-resistant strains. A 30.5% rate of faecal carriage of CAZ-AVI-resistant KPC-producing K. pneumoniae, substantially higher than that of susceptible isolates (2.8%), was observed in the COVID-19 ICU. Prevalence of faecal carriage of metallo-β-lactamase-producing organisms was low (0.5% and 0.2% for Enterobacterales and P. aeruginosa, respectively). Chromatic Super CAZ/AVI® medium showed 100% sensitivity in detecting CPE or CR-GN isolates resistant to CAZ-AVI regardless of both MIC values and carbapenemase content. Specificity was 86.8%. The Chromatic Super CAZ/AVI® medium might be implemented in rectal swab surveillance cultures for identification of patients carrying CAZ-AVI-resistant organisms to contain the spread of these difficult-to-treat pathogens.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implementation of Chromatic Super CAZ/AVI® medium for active surveillance of ceftazidime-avibactam resistance: preventing the loop from becoming a spiral

Bianco

Boattini

Comini

et al. 2022

Eur J Clin Microbiol Infect Dis

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“…Additional work will evaluate its value directly from positive blood cultures. The test can also be used as a second-line screening test of CAZ/AVI resistance after use of selective media, such, as SuperCAZ/AVI medium, which is used to detect CAZ/AVI-resistant strains ( 14 , 39 , 41 , 42 ). Further development of the test will include the potential identification of CAZ/AVI resistance in Pseudomonas aeruginosa , which has different metabolic pathways.…”

Section: Discussionmentioning

confidence: 99%

Rapid Detection of Ceftazidime/Avibactam Susceptibility/Resistance in Enterobacterales by Rapid CAZ/AVI NP Test

Nordmann,

Bouvier,

Delaval

et al. 2024

Emerg. Infect. Dis.

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We developed a novel culture-based test, the Rapid CAZ/AVI NP test, for rapid identification of ceftazidime/avibactam susceptibility/resistance in Enterobacterales. This test is based on glucose metabolization upon bacterial growth in the presence of a defined concentration of ceftazidime/avibactam (128/53 μg/mL). Bacterial growth is visually detectable by a red to yellow color change of red phenol, a pH indicator. A total of 101 well characterized enterobacterial isolates were used to evaluate the test performance. This test showed positive percent agreement of 100% and negative percent agreement of 98.5% with overall percent agreement of 99%, by comparison with the MIC gradient strip test (Etest) taken as the reference standard method. The Rapid CAZ/AVI NP test had only 1.5% major errors and 0% extremely major errors. This test is rapid (result within 2 hours 45 minutes), reliable, affordable, easily interpretable, and easy to implement in clinical microbiology laboratories without requiring any specific equipment.

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Evaluation of SuperCAZ/AVI® Medium for Screening Ceftazidime-avibactam Resistant Gram-negative Isolates

Cited by 2 publications

References 20 publications

Implementation of Chromatic Super CAZ/AVI® medium for active surveillance of ceftazidime-avibactam resistance: preventing the loop from becoming a spiral

Implementation of Chromatic Super CAZ/AVI® medium for active surveillance of ceftazidime-avibactam resistance: preventing the loop from becoming a spiral

Rapid Detection of Ceftazidime/Avibactam Susceptibility/Resistance in Enterobacterales by Rapid CAZ/AVI NP Test

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