Advertisement

Multicenter performance evaluation of the Unyvero IAI cartridge for detection of intra-abdominal infections

  • H. Ciesielczuk
  • M. Wilks
  • S. Castelain
  • M. Choquet
  • M. Morotti
  • E. Pluquet
  • V. Sambri
  • M. Tassinari
  • S. Zannoli
  • L. Cavalié
  • H. Dupont
  • H. Guet-Revillet
Original Article
  • 106 Downloads

Abstract

Intra-abdominal infections (IAIs) are one of the most common type of infections in patients with sepsis and an important cause of death in intensive care units. Early detection and treatment are necessary to reduce patient complications and improve outcomes. The Unyvero IAI Application (Curetis GmbH) is the first automated assay to rapidly and simultaneously identify a large panel of bacteria, fungi, toxins, and antibiotic resistance markers directly from IAI-related samples. The assay was evaluated in four European clinical laboratories in comparison to routine microbiological practices. A total of 300 clinical samples were tested with an overall sensitivity of 89.3% and specificity of 99.5%, while time to results was reduced by an average of about 17 h compared to identification (ID) results and 41 h compared to full antibiotic susceptibility testing (AST) results. The Unyvero IAI was able to detect additional microorganisms compared with culture, in particular anaerobes, with most detections confirmed by sequencing. The most frequent resistance markers detected were mecA/mecC (n = 25), aacA4 (n = 20), and blaCTX-M (n = 17) and carbapenemase genes were identified in nine specimens. Further studies are now required to determine the clinical impact of this new rapid test which could play a role in the successful treatment of IAI.

Keywords

Intra-abdominal infections Diagnostics Antibiotic resistance Multiplex PCR 

Notes

Acknowledgements

Curetis GmbH provided the panel reagents and instruments used in this study, and performed the additional PCR and sequencing for discrepant results analysis. All authors have reviewed and agreed to this version of the manuscript.

H. Ciesielczuk presented some of this data at ECCMID 2017.

Funding

All study reagents, consumables, and costs were provided by Curetis GmbH.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was not required for this study as there were no human participants.

References

  1. 1.
    Claridge JA, Banerjee A, Kelly KB, Leukhardt WH, Carter JW, Haridas M, Malangoni MA (2014) Bacterial species-specific hospital mortality rate for intra-abdominal infections. Surg Infect 15(3):194–199CrossRefGoogle Scholar
  2. 2.
    Labricciosa FM, Sartelli M, Abbo LM, Barbadoro P, Ansaloni L, Coccolini F, Catena F (2018) Epidemiology and risk factors for isolation of multi-drug-resistant organisms in patients with complicated intra-abdominal infections. Surg Infect 19(3):264–272CrossRefGoogle Scholar
  3. 3.
    Hu Y, Yang X, Qin J, Lu N, Cheng G, Wu N et al (2013) Metagenome-wide analysis of antibiotic resistance genes in a large cohort of human gut microbiota. Nat Commun 4:2151CrossRefGoogle Scholar
  4. 4.
    Lawley TD, Walker AW (2013) Intestinal colonization resistance. Immunology 138(1):1–11CrossRefGoogle Scholar
  5. 5.
    Sheng WH, Badal RE, Hsueh PR, SMART program (2013) Distribution of extended-spectrum β-lactamases, AmpC β-lactamases, and carbapenemases among Enterobacteriaceae isolatescausing intra-abdominal infections in the Asia-Pacific region: results of the study for Monitoring Antimicrobial Resistance Trends (SMART). Antimicrob Agents Chemother 57(7):2981–2988CrossRefGoogle Scholar
  6. 6.
    Hayajneh WA, Hajj A, Hulliel F, Sarkis DK, Irani-Hakimeh N, Kazan L, Badal RE (2015) Susceptibility trends and molecular characterization of Gram-negative bacilli associated with urinary tract infection and intra-abdominal infections in Jordan and Lebanon: SMART 2011-2013. Int J Infect Dis 35:56–61CrossRefGoogle Scholar
  7. 7.
    Buss SN, Leber A, Chapin K, Fey PD, Bankowski MJ, Jones MK et al (2015) Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. J Clin Microbiol 53(3):915–925CrossRefGoogle Scholar
  8. 8.
    Khare R, Espy MJ, Cebelinski E, Boxrud D, Sloan LM, Cunningham SA et al (2014) Comparative evaluation of two commercial multiplex panels for detection of gastrointestinal pathogens by use of clinical stool specimens. J Clin Microbiol 52(10):3667–3673CrossRefGoogle Scholar
  9. 9.
    Piralla A, Lunghi G, Ardissino G, Girello A, Premoli M, Bava E et al (2017) FilmArray GI panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea. BMC Microbiol 17(1):111CrossRefGoogle Scholar
  10. 10.
    Spina A, Kerr KG, Cormican M, Barbut F, Eigentler A, Zerva L et al (2015) Spectrum of enteropathogens detected by the FilmArray GI panel in a multicentre study of community-acquired gastroenteritis. Clin Microbiol Infect 21(8):719–728CrossRefGoogle Scholar
  11. 11.
    Edelsberg J, Berger A, Schell S, Mallick R, Kuznik A, Oster G (2008) Economic consequences of failure of initial antibiotic therapy in hospitalized adults with complicated intra-abdominal infections. Surg Infect 9(3):335–347CrossRefGoogle Scholar
  12. 12.
    Montravers P, Gauzit R, Muller C, Marmuse JP, Fichelle A, Desmonts JM (1996) Emergence of antibiotic-resistant bacteria in cases of peritonitis after intraabdominal surgery affects the efficacy of empirical antimicrobial therapy. Clin Infect Dis 23(3):486–494CrossRefGoogle Scholar
  13. 13.
    Mosdell DM, Morris DM, Voltura A, Pitcher DE, Twiest MW, Milne RL et al (1991) Antibiotic treatment for surgical peritonitis. Ann Surg 214(5):543–549CrossRefGoogle Scholar
  14. 14.
    Montravers P, Dupont H, Leone M, Constantin JM, Mertes PM, Société française d’anesthésie et de réanimation (Sfar) et al (2015b) Guidelines for management of intra-abdominal infections. Anaesth Crit Care Pain Med 34(2):117–130CrossRefGoogle Scholar
  15. 15.
    Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ et al (2010) Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 50(2):133–164CrossRefGoogle Scholar
  16. 16.
    Montravers P, Dufour G, Guglielminotti J, Desmard M, Muller C, Houissa H et al (2015a) Dynamic changes of microbial flora and therapeutic consequences in persistent peritonitis. Crit Care 19:70CrossRefGoogle Scholar
  17. 17.
    Orsi GB, Ciorba V (2013) Vancomycin resistant enterococci healthcare associated infections. Ann Ig 25(6):485–492PubMedGoogle Scholar
  18. 18.
    Cattoir V, Giard JC (2014) Antibiotic resistance in Enterococcus faecium clinical isolates. Expert Rev Anti-Infect Ther 12(2):239–248CrossRefGoogle Scholar
  19. 19.
    Montravers P, Dupont H, Gauzit R, Veber B, Auboyer C, Blin P et al (2006) Candida as a risk factor for mortality in peritonitis. Crit Care Med 34(3):646–652CrossRefGoogle Scholar
  20. 20.
    Zautner AE, Gross U, Emele MF, Hagen RM, Frickmann H (2017) More pathogenicity or just more pathogens?-on the interpretation problem of multiple pathogen detections with diagnostic multiplex assays. Front Microbiol 8:1210CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • H. Ciesielczuk
    • 1
  • M. Wilks
    • 1
    • 2
  • S. Castelain
    • 3
    • 4
  • M. Choquet
    • 3
    • 4
  • M. Morotti
    • 5
  • E. Pluquet
    • 3
    • 4
  • V. Sambri
    • 5
    • 6
  • M. Tassinari
    • 5
  • S. Zannoli
    • 5
  • L. Cavalié
    • 7
  • H. Dupont
    • 8
  • H. Guet-Revillet
    • 7
  1. 1.Department of InfectionBarts Health NHS TrustLondonUK
  2. 2.Blizard InstituteQueen Mary University of LondonLondonUK
  3. 3.Microbiology Department, Centre de Biologie HumaineCentre Hospitalier Universitaire Amiens PicardieAmiensFrance
  4. 4.EA4294Université de Picardie Jules VerneAmiensFrance
  5. 5.Unit of MicrobiologyThe Great Romagna Hub LaboratoryCesenaItaly
  6. 6.DIMESUniversity of BolognaBolognaItaly
  7. 7.Laboratoire de Bactériologie-Hygiène HospitalièreInstitut Fédératif de Biologie, Hôpital Purpan, CHU de ToulouseToulouseFrance
  8. 8.Pole D’Anesthesie-Reanimation, Centre Hospitalier Universitaire Amiens PicardieUniversité de Picardie Jules VerneAmiensFrance

Personalised recommendations