title: Multicentre evaluation of the Check-Direct CPE® assay for direct screening of carbapenemase-producing Enterobacteriaceae from rectal swabs.
abstract: OBJECTIVE
  The objective of this study was to evaluate in a multicentre survey the analytical performance of the Check-Direct CPE® assay (CDCPE), a multiplex PCR assay for the detection of carbapenemase-producing Enterobacteriaceae (CPE), directly from rectal swabs.
  
  
  METHODS
  Adult patients admitted to a high-risk unit in four participating centres were prospectively screened for CPE carriage by rectal swabbing. Samples were cultured on chromogenic CPE-selective media in the local laboratories. All growing Enterobacteriaceae strains were transferred for confirmation of carbapenemase production by multiplex PCR, together with the faecal swabs for CDCPE, to the coordinating laboratory.
  
  
  RESULTS
  Overall, 38 of the 394 samples analysed (9.6%; range 3%-20% per centre) yielded a positive signal for a carbapenemase gene with CDCPE, including 17 samples (4.3%; range 0%-15% per centre) that grew a total of 25 CPE-confirmed isolates (all OXA-48-like producers, including one isolate that simultaneously harboured a VIM-type carbapenemase). No CPE culture-positive samples were missed by CDCPE. Among the 21 samples that were CPE-positive with CDCPE but negative on culture, five were collected from previously known CPE carriers and 6/9 OXA-48-positive signals were detected at one participating centre that was undergoing a hospital-wide outbreak of OXA-48 CPE. When compared with the selective culture, the sensitivity and specificity of CDCPE were 100% and 94%, respectively.
  
  
  CONCLUSIONS
  This study showed the value of CDCPE as a tool for screening CPE carriage in an epidemiological setting with a high prevalence of OXA-48 CPE. However, the potential added value for infection control management remains to be demonstrated.
authors: National Reference Laboratory for Monitoring of Antimicrobial Resistance in Gram-negative bacteria, CHU Dinant Godinne UCL Namur, Université catholique de Louvain (UCL), 1 Avenue Docteur Gaston Therasse, 5530 Yvoir, Belgium te-din.huang@uclouvain.be.
authors: Te-Din
authors: TD
authors: Huang
authors: National Reference Laboratory for Monitoring of Antimicrobial Resistance in Gram-negative bacteria, CHU Dinant Godinne UCL Namur, Université catholique de Louvain (UCL), 1 Avenue Docteur Gaston Therasse, 5530 Yvoir, Belgium.
authors: Pierre
authors: P
authors: Bogaerts
authors: National Reference Laboratory for Monitoring of Antimicrobial Resistance in Gram-negative bacteria, CHU Dinant Godinne UCL Namur, Université catholique de Louvain (UCL), 1 Avenue Docteur Gaston Therasse, 5530 Yvoir, Belgium.
authors: Enes
authors: E
authors: Ghilani
authors: National Reference Laboratory for Monitoring of Antimicrobial Resistance in Gram-negative bacteria, CHU Dinant Godinne UCL Namur, Université catholique de Louvain (UCL), 1 Avenue Docteur Gaston Therasse, 5530 Yvoir, Belgium.
authors: Amélie
authors: A
authors: Heinrichs
authors: Centre Hospitalier Régional de la Citadelle, 1 Boulevard du 12ème de Ligne, 4000 Liège, Belgium.
authors: Pierre
authors: P
authors: Gavage
authors: Associated National Reference Laboratory for Monitoring of Antimicrobial Resistance in Gram-negative bacteria, Hôpital Erasme, Université Libre de Bruxelles (ULB), 808 Route de Lennik, 1070 Brussels, Belgium.
authors: Sandrine
authors: S
authors: Roisin
authors: Algemeen Ziekenhuis Nikolaas, 1 Moerlandstraat, 9100 Sint-Niklaas, Belgium.
authors: Elise
authors: E
authors: Willems
authors: Algemeen Ziekenhuis Nikolaas, 1 Moerlandstraat, 9100 Sint-Niklaas, Belgium.
authors: Anne-Marie
authors: AM
authors: Verbruggen
authors: Algemeen Ziekenhuis Nikolaas, 1 Moerlandstraat, 9100 Sint-Niklaas, Belgium.
authors: Hugo
authors: H
authors: Francart
authors: Associated National Reference Laboratory for Monitoring of Antimicrobial Resistance in Gram-negative bacteria, Hôpital Erasme, Université Libre de Bruxelles (ULB), 808 Route de Lennik, 1070 Brussels, Belgium.
authors: Olivier
authors: O
authors: Denis
authors: Centre Hospitalier Régional de la Citadelle, 1 Boulevard du 12ème de Ligne, 4000 Liège, Belgium.
authors: Jean-Marc
authors: JM
authors: Senterre
authors: National Reference Laboratory for Monitoring of Antimicrobial Resistance in Gram-negative bacteria, CHU Dinant Godinne UCL Namur, Université catholique de Louvain (UCL), 1 Avenue Docteur Gaston Therasse, 5530 Yvoir, Belgium.
authors: Youri
authors: Y
authors: Glupczynski
mesh_terms: D000328:Adult; D001426:Bacterial Proteins / Q000032:analysis*; D001431:Bacteriological Techniques / Q000379:methods*; D002353:Carrier State / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000302:isolation & purification; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology*; D001618:beta-Lactamases / Q000032:analysis*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: PCR; carbapenem resistance; carriage