Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae

Autor: Nora Chea, Sandra N. Bulens, Thiphasone Kongphet-Tran, Ruth Lynfield, Kristin Shaw, Paula Snippes Vagnone, Marion Kainer, Daniel Muleta, Lucy Wilson, Elisabeth Vaeth, Ghinwa Dumyati, Cathleen Concannon, Erin C. Phipps, Karissa Culbreath, Sarah J. Janelle, Wendy Bamberg, Alice Y. Guh, Brandi M. Limbago, Alexander J. Kallen
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Emerging Infectious Diseases, Vol 21, Iss 9, Pp 1611-1616 (2015)
Druh dokumentu: article
ISSN: 1080-6040
1080-6059
DOI: 10.3201/eid2109.150198
Popis: Preventing transmission of carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE) is a public health priority. A phenotype-based definition that reliably identifies CP-CRE while minimizing misclassification of non–CP-CRE could help prevention efforts. To assess possible definitions, we evaluated enterobacterial isolates that had been tested and deemed nonsusceptible to >1 carbapenem at US Emerging Infections Program sites. We determined the number of non-CP isolates that met (false positives) and CP isolates that did not meet (false negatives) the Centers for Disease Control and Prevention CRE definition in use during our study: 30% (94/312) of CRE had carbapenemase genes, and 21% (14/67) of Klebsiella pneumoniae carbapenemase–producing Klebsiella isolates had been misclassified as non-CP. A new definition requiring resistance to 1 carbapenem rarely missed CP strains, but 55% of results were false positive; adding the modified Hodge test to the definition decreased false positives to 12%. This definition should be considered for use in carbapenemase-producing CRE surveillance and prevention.
Databáze: Directory of Open Access Journals
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