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Rapid detection of carbapenemase-producing organisms directly from blood cultures positive for Gram-negative bacilli

European Journal of Clinical Microbiology & Infectious Diseases volume 40, pages 381–384 (2021)Cite this article

Abstract

Introduction

The rapid detection of carbapenemase-producing organisms (CPOs) directly from blood cultures (BCs) positive for Gram-negative bacilli (GNB) may accelerate the appropriate treatment of at-risk patients.

Objective

To evaluate the performance of two commercial assays in the rapid detection of CPOs directly from BC positive for GNB.

Methods

BC positive for GNB were tested for the presence of CPOs with β CARBA® and NG-Test® CARBA 5. A subset of sterile BC samples was seeded with multidrug-resistant (MDR) GNB. Positive BCs from clinical and seeded samples were tested directly with β CARBA and CARBA 5 from BC pellets.

Results

Sixty-five samples were tested (30 clinical, 35 seeded). β CARBA had a sensitivity, specificity, NPV, and PPV of 100%, 65.7%, 100%, and 71.4%, respectively. CARBA 5 had a sensitivity, specificity, NPV, and PPV of 90.0%, 100%, 92.1%, and 100%. False negatives for CARBA 5 occurred with 1 GES, 1 VIM-1, and 1 IMP-14.

Conclusions

This study demonstrates that the detection of CPOs directly from positive BC can be accurately achieved. β CARBA had excellent sensitivity but suffered from poor specificity. CARBA 5 had good sensitivity and specificity but is unable to detect certain CPOs.

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Affiliations

  1. University of Calgary, Calgary, AB, Canada

    William Stokes, Johann Pitout, Deirdre Church & Daniel Gregson

  2. Alberta Precision Laboratories, Diagnostic & Scientific Centre, 9, 3535 Research Rd NW, Calgary, AB, T2L 2K8, Canada

    William Stokes, Johann Pitout, Lorraine Campbell, Deirdre Church & Daniel Gregson

Authors
  1. William Stokes
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  2. Johann Pitout
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  3. Lorraine Campbell
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  4. Deirdre Church
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  5. Daniel Gregson
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Contributions

All authors were involved in creation of the study design. WS and LC performed data collection. WS performed the data analysis. All authors helped with writing the manuscript.

Corresponding author

Correspondence to William Stokes.

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Ethics

This protocol was approved by the University of Calgary Conjoint Health Research Ethics Board (#REB17-1705).

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The authors declare that they have no conflicts of interest.

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Stokes, W., Pitout, J., Campbell, L. et al. Rapid detection of carbapenemase-producing organisms directly from blood cultures positive for Gram-negative bacilli. Eur J Clin Microbiol Infect Dis 40, 381–384 (2021). https://doi.org/10.1007/s10096-020-04005-4

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  • DOI: https://doi.org/10.1007/s10096-020-04005-4

Keywords

  • CARBA 5
  • β CARBA
  • Carbapenemase-producing organisms
  • Bacteremia
  • Rapid diagnostics