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.com
Volume 7, Issue 4 (Suppl)
J Clin Exp Pathol, an open access journal
ISSN: 2161-0681
Euro Pathology 2017
August 02-03, 2017
13
th
EUROPEAN PATHOLOGY CONGRESS
August 02-03, 2017 Milan, Italy
Evaluation of CepheidXpert-Carba-Rassay for the detection of carbapenemase-producing organisms
Jaber Aslanzadeh
Hartford Health System, USA
Background &Aim:
Infections with carbapenem resistant microorganisms are associated with a high morbidity and mortality.
Carbapenem resistance makes empirical and targeted treatment of infections challenging. Carbapenem resistance can arise by
several mechanisms with the greatest emphasis on those bacteria that have acquired transferable carbapenemase genes such as
KPC, OXA 48, IMP-1, VIM
and
NDM
. The goal of this study was to compare the performance of the Cepheid Xpert-Carba-R
assay to modify Hodge test (MHT) and carbapenem inactivation method (CIM).
Method:
MHT, CIMand Carba-Rwere performed on a panel of 24 isolates that included
Acinetobacter baumannii
(7),
Klebsiella
pneumoniae
(9),
Klebsiella oxytoca
(1)
Citrobacter freundii
(1),
E. coli
(3),
Morganella morganii
(1) and
Pseudomonas aeruginosa
(2) as well as 18 carbapenem resistant organisms isolated from patients at Hartford Hospital [
E. coli
(11),
K. oxytoca
(3),
K.
pneumoniae
(7),
P. aeruginosa
(1) and
Serratia marcescens
(1)]. Antimicrobial susceptibility of the panel isolates revealed that
all except for one
A. baumannii, one E. coli
and
one K. pneumoniae
were resistant or intermediate to one or more carbapenems.
Similarly, antimicrobial susceptibility of the clinical isolates revealed that all isolates were resistant or intermediate to one or
more carbapenems except for
S. marcescens.
Results:
Of the 42 isolates, 21 isolates tested negative and 15 isolates tested positive for carbapenemase by all three tests.
Two isolates (
Acinetobacter baumannii
) tested were positive by MHT, negative by CIM and CarbaR PCR and; one isolate
(
Pseudomonas aeruginosa
) was tested positive by CIM, negative by MHT and CarbaR PCR. One isolate (
Acinetobacter
baumannii
) tested positive by MHT and CIM, tested negative by CarbaR PCR and; one isolate (
Acinetobacter baumannii
)
tested positive by CarbaR PCR (NDM) and MHT tested negative by CIM. One isolate (
Klebsiella oxytoca
) tested positive by
CarbaR (NDM), tested negative by MHT and CIM. This was considered as a true positive missed by MHT and CIM.
Conclusions:
CarbaR detected all isolates with KPC, OXA 48, IMP-1, VIM and NDM carbapenemases. Both MHT and CIM
were associated with false positive and false negative results. The turn-around time for CarbaR was less than 90 minutes
compared to 24 hours for MHT and CIM.
Biography
Jaber Aslanzadeh has completed his PhD at American Board of Medical Microbiology (ABMM). He is the Director of Clinical Microbiology at Hartford Hospital, USA.
Currently, he is an Associate Professor of Laboratory Medicine at University of Connecticut School of Medicine, Farmington, USA.
jaber.aslanzadeh@hhchealth.orgJaber Aslanzadeh, J Clin Exp Pathol 2017, 7:4(Suppl)
DOI: 10.4172/2161-0681-C1-038