2123. Rapid Phenotypic Detection of Gram-Negative Bacilli-Resistant to Oximinocephalosporins and Carbapenems in Positive Blood Cultures Using a Novel Protocol

Autor:	Soad Yusef, Diego Fernando Josa, Stephanie Crevoisier, Rafael Leal, Isabel Cristina Torres, Gerson Arias, Gisell Bustos-Moya, Edwin Silva, Juan Pablo Osorio, Natalia Lopez, Luis F. Reyes
Rok vydání:	2019
Předmět:	Bacillus (shape) Carbapenem biology medicine.diagnostic_test Klebsiella pneumoniae medicine.drug_class Pseudomonas aeruginosa business.industry Gram Negative Bacillus Antibiotics biology.organism_classification medicine.disease_cause medicine.disease Microbiology Abstracts Infectious Diseases Oncology Bacteremia Poster Abstracts medicine Blood culture business medicine.drug
Zdroj:	Open Forum Infectious Diseases
ISSN:	2328-8957
DOI:	10.1093/ofid/ofz360.1803
Popis:	Background Early and adequate antibiotic treatment are the cornerstones to improve clinical outcomes in patients with Bloodstream infections (BSI). Delays in appropriate antimicrobial therapy have catastrophic consequences for patients with BSI. Microbiological characterization of multi-drug-resistant pathogens (MDRP) allow clinicians to provide appropriate treatments. Current available microbiologic techniques may take-up to 96 hours to identify causative pathogens and its resistant patterns. Therefore, there is an important need to develop rapid diagnostic strategies for MDRP. However, rapid detection techniques are costly and are not widely available. We tested a modified protocol designed to detect Gram-negative bacilli (GNB) resistant to oximinocephalosporins and carbapenems from positive blood cultures. Methods This is a prospective, cohort study of consecutive patients with bacteremia. We developed a modified protocol using HB&L® system to detect MDRP. We then attempted to determine accuracy, concordance and reduction of identification time of this novel method in a reference hospital. Descriptive statistics and logistical regressions were used. Results Ninety-six patients with BSI were included in the study. A total of 161 positive blood cultures were analyzed. Escherichia coli (50%, 81/161) was the most frequently identified pathogen followed by Klebsiella pneumoniae (15%, 24/161) and Pseudomonas aeruginosa (8%, 13/161). 32% of isolations had usual resistance patters. However, in 29/161 (18%) of identified pathogens were producer of carbapenemasases and 21/161 (13%) of extended-spectrum β-lactamases. Concordance among our HB&L® modified protocol and traditional method was 99% (159/161). Finally, identification times were significantly shorter using our HB&L® modified protocol than traditional methods (Mean, hours [SD], 20.8 [6.22] vs. 62.8 [6.22], P < 0.001). Conclusion Here we provided novel evidence that using our HB&L® modified protocol is an effective strategy to reduce the time to MDRP detection/identification; with a great concordance rate when compared with the gold standard. Further studies are needed to confirm these findings and to determine whether this method may improve clinical outcomes. Disclosures All authors: No reported disclosures.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c678ff5d0b296b0798678d0aa2f68b47 https://doi.org/10.1093/ofid/ofz360.1803 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.