4.5 Article

Short Report Integrating rapid diagnostics in Gram-negative bloodstream infections of patients colonized by carbapenemase-producing Enterobacterales

期刊

JOURNAL OF HOSPITAL INFECTION
卷 110, 期 -, 页码 84-88

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W B SAUNDERS CO LTD
DOI: 10.1016/j.jhin.2021.01.015

关键词

Rapid diagnostics; MALDI-TOF MS; Carbapenemase producing; Enterobacterales; Bloodstream infection; Surveillance screening; Rectal carriage

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A fast-track diagnostic approach was implemented for Gram-negative bloodstream infections among carbapenemase-producing Enterobacterales carriers. The combination of direct MALDI-TOF MS and NG-Test Carba 5 proved to be a reliable and cost-effective tool for accelerating laboratory diagnosis of CPE BSI in high-risk patient cohorts such as CPE carriers.
We implemented a fast-track diagnostic approach for Gram-negative bloodstram infections (BSIs) among carbapenemase-producing Enterobacterales (CPE) carriers. Within a large cohort of patients with CPE rectal carriage, 18.1% developed Gram-negative BSIs, of which 69.5% were caused by CPE. Direct matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis provided reliable identification in 97% and 53.8% of monomicrobical blood cultures positive to Enterobacterales and non fermenting Gram-negative species, respectively. Overall, sensitivity and specificity of NG-Test Carba 5 compared with the composite reference method after discrepant analysis were 100%, in polimicrobial blood cultures too. The combined use of direct MALDI-TOF MS and NG-Test Carba 5 assay might be a reliable and cost-effective tool for accelerating the laboratory diagnosis of CPE BSI in cohorts of high-risk patients such as CPE carriers. (c) 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. We implemented a fast-track diagnostic approach for Gram-negative bloodstram infections (BSIs) among carbapenemase-producing Enterobacterales (CPE) carriers. Within a large cohort of patients with CPE rectal carriage, 18.1% developed Gram-negative BSIs, of which 69.5% were caused by CPE. Direct matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis provided reliable identification in 97% and 53.8% of monomicrobical blood cultures positive to Enterobacterales and nonfermenting Gram-negative species, respectively. Overall, sensitivity and specificity of NG-Test Carba 5 compared with the composite reference method after discrepant analysis were 100%, in polimicrobial blood cultures too. The combined use of direct MALDI-TOF MS and NG-Test Carba 5 assay might be a reliable and cost-effective tool for accelerating the laboratory diagnosis of CPE BSI in cohorts of high-risk patients such as CPE carriers. ? 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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