Diagnostic performance of the Xpert Carba-R assay for active surveillance of rectal carbapenemase-producing organisms in intensive care unit patients
- Authors
- Ko, Young Jin; Kim, Jeeyong; Kim, Ha-Nui; Yoon, Soo-Young; Lim, Chae Seung; Lee, Chang Kyu
- Issue Date
- 29-7월-2019
- Publisher
- BMC
- Keywords
- Carbapenemase; Surveillance; Xpert Carba-R assay; Gram-negative bacteria; Intensive care unit; Molecular methods; Chromogenic culture
- Citation
- ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL, v.8
- Indexed
- SCIE
SCOPUS
- Journal Title
- ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL
- Volume
- 8
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/64053
- DOI
- 10.1186/s13756-019-0579-2
- ISSN
- 2047-2994
- Abstract
- BackgroundThere are growing concerns regarding the spread of carbapenemase-producing organisms (CPOs) among patients in long-term care facilities (LTCFs) and hospitals in South Korea. We have established a screening protocol for the detection of CPOs in high-risk patients upon admission to intensive care units (ICUs). The diagnostic performance of the Xpert Carba-R assay was compared to that of rectal culture for CPO detection in high-risk patients upon ICU admission.MethodsA total of 408 consecutive rectal swabs were obtained from December 2016 to December 2017. CPO screening was performed using the Xpert Carba-R assay (Cepheid, Sunnyvale, CA, USA). When a carbapenemase gene was detected, additional rectal swabs were incubated overnight and inoculated on chromID CARBA medium (bioMerieux, Marcy l'Etoile, France). Bacterial carbapenemase genes, including bla(KPC), bla(NDM), bla(VIM), bla(IMP-1), and bla(OXA-48), were confirmed by conventional PCR. The diagnostic performance of the Carba-R assay was ascertained based on the culture results.ResultsThe prevalence of CPO carriage was 7.4% according to the Carba-R assay and 3.7% according to rectal culture. The median Ct values of IMP-1 and KPC were significantly different (35.2 vs. 26.6, P=0.0143). The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the Carba-R assay were 100.0% (95% confidence interval [CI], 78.2-100.0), 96.7% (94.4-98.2), 53.6% (40.4-66.4) and 100.0% (99.0-100.0), respectively.ConclusionsWe demonstrated the prevalence of CPO carriage in high-risk patients upon ICU admission and evaluated the diagnostic performance of the Carba-R assay. The combined use of the Xpert Carba-R assay and culture produces rapid and reliable results for the active surveillance of rectal CPO in ICU patients.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
- Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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