title: Laboratory detection of intestinal carriage of carbapenemase-producing Enterobacteriaceae - A comparison of algorithms using the Carba NP test.
abstract: Stool specimens spiked with a panel of 46 carbapenemase-producing Enterobacteriaceae (CPE) and 59 non-carbapenemase producers were used to compare the diagnostic accuracy of 4 testing algorithms for the detection of intestinal carriage of CPE: (1) culture on Brilliance ESBL agar followed by the Carba NP test; (2) Brilliance ESBL followed by the Carba NP test, plus chromID OXA-48 agar with no Carba NP test; (3) chromID CARBA agar followed by the Carba NP test; (4) chromID CARBA followed by the Carba NP test, plus chromID OXA-48 with no Carba NP test. All algorithms were 100% specific. When comparing algorithms (1) and (3), Brilliance ESBL agar followed by the Carba NP test was significantly more sensitive than the equivalent chromID CARBA algorithm at the lower of 2 inoculum strengths tested (84.8% versus 63.0%, respectively [P<0.02]). With the addition of chromID OXA-48 agar, the sensitivity of these algorithms was marginally increased.
authors.affiliation: Microbiology Department, Melbourne Pathology, 103 Victoria Pde, Collingwood, Melbourne, 3066, Australia. Electronic address: jaknox2@yahoo.com.au.
authors.forename: James
authors.initials: J
authors.lastname: Knox
authors.affiliation: Microbiology Department, Melbourne Pathology, 103 Victoria Pde, Collingwood, Melbourne, 3066, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: Gregory
authors.affiliation: Microbiology Department, Melbourne Pathology, 103 Victoria Pde, Collingwood, Melbourne, 3066, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Prendergast
authors.affiliation: Microbiology Department, Melbourne Pathology, 103 Victoria Pde, Collingwood, Melbourne, 3066, Australia.
authors.forename: Chandrika
authors.initials: C
authors.lastname: Perera
authors.affiliation: Microbiology Department, Sullivan Nicolaides Pathology, PO, Box 344, Indooroopilly, Brisbane, 4068, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Robson
authors.affiliation: Microbiology Department, Melbourne Pathology, 103 Victoria Pde, Collingwood, Melbourne, 3066, Australia.
authors.forename: Lynette
authors.initials: L
authors.lastname: Waring
mesh_terms: D000465:Algorithms; D001426:Bacterial Proteins / Q000378:metabolism*; D001431:Bacteriological Techniques / Q000379:methods*; D002353:Carrier State / Q000382:microbiology*; D003955:Diagnostic Tests, Routine / Q000379:methods; D004755:Enterobacteriaceae / Q000201:enzymology / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D005243:Feces / Q000382:microbiology*; D006801:Humans; D012680:Sensitivity and Specificity; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Carba NP test; Carbapenemase; Enterobacteriaceae; OXA-48; Sensitivity; Specificity