title: Performance of the BD MAX™ instrument with Check-Direct CPE real-time PCR for the detection of carbapenemase genes from rectal swabs, in a setting with endemic dissemination of carbapenemase-producing Enterobacteriaceae.
abstract: Carbapenemase-producing Enterobacteriaceae (CPE) represent an increasing public health issue and the early detection of colonization by CPE can help the implementation of infection control measures among inpatients. In this study, BD MAX Check-Direct CPE screen, with two different Master Mixes (BDMix and CPMix), using the automatic BD MAX(™) instrument, was evaluated for the detection of blaKPC, blaOXA-48, blaVIM and blaNDM genes, in comparison to selective broth enrichment and direct culture from rectal swabs. Among a total of 557 rectal swabs samples, 29 (5.2%) tested positive for CPE (23 for blaKPC, 5 for blaVIM and one for blaOXA-48). The sensitivity, specificity, positive and negative likelihood ratios values were 93.1%, 97.3%, 34.5 and 0.07, for BMix, and 100%, 97.1 %, 34.5 and 0 for CPMix, respectively. Five samples were positive with molecular methods only. The turn-around time was reduced from 18-24 hours (direct culture), or 48 h (broth enrichment) to only 3 h.
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Antonelli
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Arena
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Giani
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Olga Lorenza
authors.initials: OL
authors.lastname: Colavecchio
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Stoyanka Valentinova
authors.initials: SV
authors.lastname: Valeva
authors.affiliation: Becton Dickinson, Franklin Lakes, New Jersey, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Paule
authors.affiliation: Check-Points Health, Wageningen, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Boleij
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Department of Medical Biotechnologies, University of Siena, Siena, Italy; Florence Careggi University Hospital, Florence; Don Carlo Gnocchi Foundation, Florence, Italy. Electronic address: gianmaria.rossolini@unifi.it.
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Rossolini
mesh_terms: D057205:Automation, Laboratory / Q000379:methods; D001426:Bacterial Proteins / Q000032:analysis* / Q000235:genetics; D001431:Bacteriological Techniques / Q000379:methods*; D019353:Endemic Diseases; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012007:Rectum / Q000382:microbiology; D012680:Sensitivity and Specificity; D001618:beta-Lactamases / Q000032:analysis* / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: CPE; Carbapenemases; RT-PCR