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

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Chea, Nora ; Bulens, Sandra N. ; Kongphet-Tran, Thiphasone ; Lynfield, Ruth ; Shaw, Kristin M. ; Vagnone, Paula Snippes ; Kainer, Marion A. ; Muleta, Daniel B. ; Wilson, Lucy ; Vaeth, Elisabeth ; Dumyati, Ghinwa ; Concannon, Cathleen ; Phipps, Erin C. ; Culbreath, Karissa ; Janelle, Sarah J. ; Bamberg, Wendy M. ; Guh, Alice Y. ; Limbago, Brandi ; Kallen, Alexander J.
• Description:
  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.
• Subjects:
  Anti-Bacterial Agents Bacterial Proteins Beta-Lactamases Carbapenems Communicable Disease Control Communicable Diseases, Emerging Diagnostic Tests, Routine Drug Resistance, Bacterial Emerging Infections Program (EIP) Enterobacteriacea Enterobacteriaceae Infections Humans Phenotype Public Health Surveillance

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• Source:
  Emerg Infect Dis. 21(9):1611-1616
• Pubmed ID:
  26290955
• Pubmed Central ID:
  PMC4550143
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Location:
  North America
• Volume:
  21
• Issue:
  9
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:1b1ce53c72de04cf21b0b4128ee94f0caee721c4ba2dbc25826ada794415657f
• Download URL:
  https://stacks.cdc.gov/view/cdc/33147/cdc_33147_DS1.pdf
• File Type:
  [PDF - 449.37 KB ]