New screening method to detect carriage of carbapenemase-producing Enterobacteriaceae in patients within 24 hours

Hanemaaijer, N.M.; Nijhuis, Roel H. T.; Slotboom, Brenda; Mascini, Ellen M.; Zwet, A. A. Van

doi:10.1016/j.jhin.2014.03.003

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…None of these tests are designed to be used on blood cultures. Some of these tests detect the target genes (KPC, OXA-48, NDM and VIM) in multistep reactions and are therefore timeconsuming, and many also lack an internal control (Kaase et al 2012;Nijhuis et al 2013;Hanemaaijer et al 2014).…”

Section: Discussionmentioning

confidence: 99%

Multiplex real-time PCR probe-based for identification of strains producing: OXA48, VIM, KPC and NDM

Favaro

Sarti

Fontana

2014

World J Microbiol Biotechnol

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The spread of multi-resistant enterobacteria, particularly carbapenem-resistant Enterobacteriaceae (CRE), in both community and hospital settings is a global problem. The phenotypic identification of CRE is complex, occasionally inconclusive and time consuming. However, commercially available molecular assays are very expensive, and many do not allow the simultaneous identification of all genetic markers of resistance that have been recognised in CRE (bla KPC, bla OXA-48, bla VIM and bla NDM). The aim of the present study is to describe a new test: a multiplex real time PCR probe-based assay designed for the simultaneous detection of KPC, OXA-48, VIM and NDM in a short time (no longer than 90 min from the extraction of DNA to detection). Our assay correctly identified 63 CRE isolates and all standard reference strains tested, in agreement with and extending the results of phenotypic identification tests; additionally, a KPC-VIM co-expressing Enterobacter aerogenes isolate was identified using the new assay, whereas traditional methods failed to detect it. The assay was also able to correctly detect 28 CRE-producers from 50 positive blood cultures, again detecting, in four specimens, the presence of CRE co-expressing KPC and VIM, which were only partially identified by traditional methods. Finally, when used directly on rectal swabs, the assay enabled the identification of CRE-carrier patients, for whom isolation is mandatory in a hospital setting.

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Section: Discussionmentioning

confidence: 99%

Multiplex real-time PCR probe-based for identification of strains producing: OXA48, VIM, KPC and NDM

Favaro

Sarti

Fontana

2014

World J Microbiol Biotechnol

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“…Multiplex real‐time PCR has been used in initial screenings to detect NDM, VIM, IMP, GES, KPC and OXA‐48 CPEs in rectal and throat swabs, as well as in peri‐anal and stool samples, with a sensitivity, specificity, positive and negative predictive values of 100, 93·3, 46·6 and 100% respectively (Hanemaaijer et al . ; Lowman et al . ).…”

Section: Genotypic Methodsmentioning

confidence: 99%

“…Using the commercial Check‐MDR Carba assay (Check‐Points), also based on real‐time multiplex PCR technology, Hanemaaijer et al . () detected KPC, NDM, OXA‐48, VIM and IMP from rectal and throat swabs after incubation and DNA extraction. The bacterial isolates were incubated overnight in a solution of vancomycin (50 mg l −1 )‐ertapenem (0·25 mg l −1 ) and vancomycin (50 mg l −1 )‐ceftazidime (2 mg l −1 ), after which both solutions were mixed, lysed with a chromopeptidase at 37°C for 15 min, and centrifuged to obtain a supernatant that was used for the Check‐MDR Carba assay (Hanemaaijer et al .…”

Section: Genotypic Methodsmentioning

confidence: 99%

Review of established and innovative detection methods for carbapenemase-producing Gram-negative bacteria

2015

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SummaryThe minimal antibiotic options for carbapenemase-producing Gram-negative bacteria necessitate their rapid detection. A literature review of a variety of phenotypic and genotypic methods is presented. Advances in culture methods and screening media are still subject to long incubation hours. Biochemical methods have shorter turnaround times and higher sensitivities and specificities, but cannot differentiate between various types and variants. Spectrophotometric methods are cheap and efficient, but are uncommon in many clinical settings, while the MALDI-TOF MS is promising for species identification, typing and resistance gene determination. Although next generation sequencing (NGS) technologies provide a better platform to detect, type and characterize carbapenem-resistant bacteria, the different NGS platforms, the large computer memories and space needed to process and store genomic data and the nonuniformity in data analysis platforms are still a challenge. The sensitivities, specificities and turnaround times recorded in the various studies reviewed favours the use of the biochemical tests (Carba NP or Rapid Carb screen tests) for the detection of putative carbapenemaseproducing isolates. MALDI-TOF MS and/or molecular methods like microarray, loop-mediated isothermal amplification and real-time multiplex PCR assays could be used for further characterization in a reference laboratory. NGS may be used for advanced epidemiological and molecular studies.

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“…Where rapid results would be clinically useful it may also be useful to screen using nucleic acid amplification tests, but these tests may not be sensitive enough for them to be recommended as sole screening tests. 8,9 The need for further screening should be determined on a case-by-case basis.…”

Section: Screening Of Patientsmentioning

confidence: 99%

Casualties of war: the infection control assessment of civilians transferred from conflict zones to specialist units overseas for treatment

Morton

Gray

2015

Journal of Hospital Infection

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The casualties of global conflict attract media attention and sympathy in public, governmental, and non-governmental circles. Hospitals in developed countries offering specialist reconstructive or tertiary services are not infrequently asked to accept civilian patients from overseas conflict for complex surgical procedures or rehabilitation. Concern about the infection prevention and control risks posed by these patients, and the lack of a good evidence base on which to base measured precautions, means that the precautionary principle of accepting zero risk is usually followed. The aim of this article is to highlight infection control considerations that may be required when treating casualties from overseas conflict, based partly on our own experience. Currently there is a lack of published evidence and national consensus on how to manage these patients. The precautionary principle requires that there is an ongoing search for evidence and knowledge that can be used to move towards more traditional risk management. We propose that only by gathering the experiences of the many individual hospitals that have each cared for small numbers of such patients can such evidence and knowledge be assimilated.

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New screening method to detect carriage of carbapenemase-producing Enterobacteriaceae in patients within 24 hours

Cited by 7 publications

References 6 publications

Multiplex real-time PCR probe-based for identification of strains producing: OXA48, VIM, KPC and NDM

Multiplex real-time PCR probe-based for identification of strains producing: OXA48, VIM, KPC and NDM

Review of established and innovative detection methods for carbapenemase-producing Gram-negative bacteria

Casualties of war: the infection control assessment of civilians transferred from conflict zones to specialist units overseas for treatment

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