title: Evaluation of the eazyplex® SuperBug CRE system for rapid detection of carbapenemases and ESBLs in clinical Enterobacteriaceae isolates recovered at two Spanish hospitals.
abstract: OBJECTIVE
  To evaluate the performance of the eazyplex(®) SuperBug CRE system, a loop-mediated isothermal amplification (LAMP)-based system, for confirming the presence of carbapenemases in addition to CTX-M-type ESBLs in previously genotypically and/or phenotypically characterized clinical Enterobacteriaceae isolates recovered in two centres in Spain.
  
  
  METHODS
  A collection of 94 carbapenemase-producing strains previously characterized by conventional PCR and sequencing and a total of 45 prospectively collected isolates with phenotypes compatible with the presence of a carbapenemase were tested with the eazyplex(®) SuperBug CRE system. In both cases, the presence of an ESBL was also assessed. Results were evaluated to establish the accuracy of this rapid LAMP-based system as well as to determine the concordance between all approaches.
  
  
  RESULTS
  The eazyplex(®) SuperBug CRE system correctly detected bla carbapenemase genes with or without blaCTX-M genes in 100% of the molecularly characterized strains. Absolute concordance (100%) was also observed in the case of isolates with phenotypes compatible with the presence of a carbapenemase with or without an ESBL inferred by susceptibility patterns and phenotypic inhibitory profiles. Determinations performed with the eazyplex(®) SuperBug CRE system took 15 min.
  
  
  CONCLUSIONS
  The eazyplex(®) SuperBug CRE system proved to be a powerful tool for the detection of different carbapenemases as well as CTX-M-type ESBLs in Enterobacteriaceae with a rapid resolution time. The test has the high-performance parameters attributable to the sensitivity and specificity already demonstrated by LAMP-based assays. These results assure the usefulness of this test for routine rapid confirmation of carbapenemase-producing Enterobacteriaceae.
authors.affiliation: Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: García-Fernández
authors.affiliation: Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain Red Española de Investigación en Patología Infecciosa, Madrid, Spain mariaisabel.morosini@salud.madrid.org.
authors.forename: María-Isabel
authors.initials: MI
authors.lastname: Morosini
authors.affiliation: Department of Clinical Microbiology, CDB, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Marco
authors.affiliation: Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain Red Española de Investigación en Patología Infecciosa, Madrid, Spain.
authors.forename: Desirèe
authors.initials: D
authors.lastname: Gijón
authors.affiliation: Department of Clinical Microbiology, CDB, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vergara
authors.affiliation: Department of Clinical Microbiology, CDB, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Vila
authors.affiliation: Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain Red Española de Investigación en Patología Infecciosa, Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ruiz-Garbajosa
authors.affiliation: Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain Red Española de Investigación en Patología Infecciosa, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Cantón
mesh_terms: D001431:Bacteriological Techniques / Q000379:methods*; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D006761:Hospitals; D006801:Humans; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013030:Spain; D013997:Time Factors; D001618:beta-Lactamases / Q000032:analysis* / Q000235:genetics
chemical_list: D001618:beta-Lactamases
keywords: LAMP; isothermal amplification; β-lactamases