Ann Lab Med.  2016 Mar;36(2):162-165. 10.3343/alm.2016.36.2.162.

Xpert CARBA-R Assay for the Detection of Carbapenemase-Producing Organisms in Intensive Care Unit Patients of a Korean Tertiary Care Hospital

Affiliations
  • 1Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea. deyong@yuhs.ac
  • 2Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Carbapenemase-producing organisms (CPO) are rapidly disseminating worldwide, and their presence in tertiary care hospitals poses a significant threat to the management of nosocomial infections. There is a need to control CPO, especially in intensive care unit (ICU) patients, because these organisms are resistant to most beta-lactam antibiotics and are easily transmitted. At present, the identification of CPO is time-consuming; hence, this study focused on the use of the Xpert CARBA-R assay (Cepheid, USA) to determine intestinal colonization rates of CPO in patients admitted to the ICU of a tertiary care hospital in Korea. Forty clinical stool samples were collected and inoculated both in a CARBA-R cartridge and in conventional culture plates. The CARBA-R assay required only ~one hour to screen CPO, while the time required for conventional culture was over three days. We also found that the prevalences of intestinal colonization by carbapenem-resistant organisms and Enterobacteriaceae were 17.5% (7 out of 40) and 7.5% (3 out of 40), respectively. Among the colonizing strains, three that contained carbapenemase, including Klebsiella pneumonia carbapenemase (KPC), and imipenem (IMP) and Verona integron-mediated metallo-beta-lactamase (VIM) were found. With its convenience, the Xpert CARBA-R assay can be included in CPO surveillance strategies.

Keyword

Carbapenemase-producing organisms; Carbapenem-resistant organisms; Intensive care unit; Colonization; Xpert CARBA-R

MeSH Terms

Anti-Bacterial Agents/pharmacology
Bacterial Proteins/*genetics/metabolism
DNA, Bacterial/analysis
Drug Resistance, Multiple, Bacterial/genetics
Enterobacteriaceae/drug effects/genetics/*isolation & purification
Feces/microbiology
Humans
Imipenem/pharmacology
Intensive Care Units
Klebsiella pneumoniae/drug effects/genetics/*isolation & purification
Reagent Kits, Diagnostic
Real-Time Polymerase Chain Reaction
Republic of Korea
Tertiary Healthcare
beta-Lactamases/*genetics/metabolism
Anti-Bacterial Agents
Bacterial Proteins
DNA, Bacterial
Imipenem
Reagent Kits, Diagnostic
beta-Lactamases
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