Details der Publikation - Implementation of Chromatic Super CAZ/$ AVI^{®} $ medium for active surveillance of ceftazidime-avibactam resistance: preventing the loop from becoming a spiral

Implementation of Chromatic Super CAZ/$ AVI^{®} $ medium for active surveillance of ceftazidime-avibactam resistance: preventing the loop from becoming a spiral

Abstract Acquired resistance towards ceftazidime-avibactam (CAZ-AVI) is increasingly reported. Several mechanisms can be involved, but mutations in the Ω-loop region of β-lactamases are the most described. Herein, we assessed the implementation of Chromatic Super CAZ/$ AVI^{®} $ medium in rectal swab surveillance cultures in a geographic area with endemic distribution of KPC-producing Klebsiella pneumoniae. Routine rectal swabs collected from the intensive care unit (ICU) and non-ICU patients were screened for carbapenemase-producing Enterobacterales (CPE), carbapenem-resistant Gram-negative organisms (CR-GN) and CAZ-AVI-resistant organisms by Chromatic CRE and Super CAZ/$ AVI^{®} $ media. Among the 1839 patients screened, 146 (7.9%) were found to be colonized by one or more CPE and/or CR-GN isolates during hospitalization. Overall, among colonized patients the most common bacteria encountered were KPC-producing Enterobacterales (n = 60; 41.1%), carbapenem-resistant Pseudomonas aeruginosa (n = 41; 28.1%) and carbapenem-resistant A. baumannii (n = 34; 23.3%). Among patients colonized by KPC-producing Enterobacterales, thirty-five (58.3%) had CAZ-AVI-resistant strains. A 30.5% rate of faecal carriage of CAZ-AVI-resistant KPC-producing K. pneumoniae, substantially higher than that of susceptible isolates (2.8%), was observed in the COVID-19 ICU. Prevalence of faecal carriage of metallo-β-lactamase-producing organisms was low (0.5% and 0.2% for Enterobacterales and P. aeruginosa, respectively). Chromatic Super CAZ/$ AVI^{®} $ medium showed 100% sensitivity in detecting CPE or CR-GN isolates resistant to CAZ-AVI regardless of both MIC values and carbapenemase content. Specificity was 86.8%. The Chromatic Super CAZ/$ AVI^{®} $ medium might be implemented in rectal swab surveillance cultures for identification of patients carrying CAZ-AVI-resistant organisms to contain the spread of these difficult-to-treat pathogens..

Medienart:	E-Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:41
Enthalten in:	European journal of clinical microbiology & infectious diseases - 41(2022), 9 vom: 06. Aug., Seite 1165-1171

Sprache:	Englisch

Beteiligte Personen:	Bianco, Gabriele [VerfasserIn] Boattini, Matteo [VerfasserIn] Comini, Sara [VerfasserIn] Leone, Alessio [VerfasserIn] Bondi, Alessandro [VerfasserIn] Zaccaria, Teresa [VerfasserIn] Cavallo, Rossana [VerfasserIn] Costa, Cristina [VerfasserIn]

Links:	Volltext [kostenfrei]

Themen:	Carbapenemase Carbapenemase detection Ceftazidime-avibactam resistance KPC Outbreak Surveillance culture

RVK:	RVK Klassifikation ELIB24 ELIB09

Anmerkungen:	© The Author(s) 2022

doi:	10.1007/s10096-022-04480-x

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2131815093

Internformat


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520			\|a Abstract Acquired resistance towards ceftazidime-avibactam (CAZ-AVI) is increasingly reported. Several mechanisms can be involved, but mutations in the Ω-loop region of β-lactamases are the most described. Herein, we assessed the implementation of Chromatic Super CAZ/$ AVI^{®} $ medium in rectal swab surveillance cultures in a geographic area with endemic distribution of KPC-producing Klebsiella pneumoniae. Routine rectal swabs collected from the intensive care unit (ICU) and non-ICU patients were screened for carbapenemase-producing Enterobacterales (CPE), carbapenem-resistant Gram-negative organisms (CR-GN) and CAZ-AVI-resistant organisms by Chromatic CRE and Super CAZ/$ AVI^{®} $ media. Among the 1839 patients screened, 146 (7.9%) were found to be colonized by one or more CPE and/or CR-GN isolates during hospitalization. Overall, among colonized patients the most common bacteria encountered were KPC-producing Enterobacterales (n = 60; 41.1%), carbapenem-resistant Pseudomonas aeruginosa (n = 41; 28.1%) and carbapenem-resistant A. baumannii (n = 34; 23.3%). Among patients colonized by KPC-producing Enterobacterales, thirty-five (58.3%) had CAZ-AVI-resistant strains. A 30.5% rate of faecal carriage of CAZ-AVI-resistant KPC-producing K. pneumoniae, substantially higher than that of susceptible isolates (2.8%), was observed in the COVID-19 ICU. Prevalence of faecal carriage of metallo-β-lactamase-producing organisms was low (0.5% and 0.2% for Enterobacterales and P. aeruginosa, respectively). Chromatic Super CAZ/$ AVI^{®} $ medium showed 100% sensitivity in detecting CPE or CR-GN isolates resistant to CAZ-AVI regardless of both MIC values and carbapenemase content. Specificity was 86.8%. The Chromatic Super CAZ/$ AVI^{®} $ medium might be implemented in rectal swab surveillance cultures for identification of patients carrying CAZ-AVI-resistant organisms to contain the spread of these difficult-to-treat pathogens.
650		4	\|a Ceftazidime-avibactam resistance
650		4	\|a Outbreak
650		4	\|a Carbapenemase
650		4	\|a KPC
650		4	\|a Surveillance culture
650		4	\|a Carbapenemase detection
700	1		\|a Boattini, Matteo \|4 aut
700	1		\|a Comini, Sara \|4 aut
700	1		\|a Leone, Alessio \|4 aut
700	1		\|a Bondi, Alessandro \|4 aut
700	1		\|a Zaccaria, Teresa \|4 aut
700	1		\|a Cavallo, Rossana \|4 aut
700	1		\|a Costa, Cristina \|4 aut
773	0	8	\|i Enthalten in \|t European journal of clinical microbiology & infectious diseases \|d Springer Berlin Heidelberg, 1982 \|g 41(2022), 9 vom: 06. Aug., Seite 1165-1171 \|h Online-Ressource \|w (DE-627)25372273X \|w (DE-600)1459049-9 \|w (DE-576)072372575 \|x 1435-4373 \|7 nnns
773	1	8	\|g volume:41 \|g year:2022 \|g number:9 \|g day:06 \|g month:08 \|g pages:1165-1171
856	4	0	\|u https://dx.doi.org/10.1007/s10096-022-04480-x \|z kostenfrei \|3 Volltext
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912			\|a GBV_ILN_187
912			\|a GBV_ILN_213
912			\|a GBV_ILN_224
912			\|a GBV_ILN_230
912			\|a GBV_ILN_250
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912			\|a GBV_ILN_285
912			\|a GBV_ILN_293
912			\|a GBV_ILN_370
912			\|a GBV_ILN_602
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912			\|a GBV_ILN_2005
912			\|a GBV_ILN_2006
912			\|a GBV_ILN_2007
912			\|a GBV_ILN_2008
912			\|a GBV_ILN_2009
912			\|a GBV_ILN_2010
912			\|a GBV_ILN_2011
912			\|a GBV_ILN_2014
912			\|a GBV_ILN_2015
912			\|a GBV_ILN_2020
912			\|a GBV_ILN_2021
912			\|a GBV_ILN_2025
912			\|a GBV_ILN_2026
912			\|a GBV_ILN_2027
912			\|a GBV_ILN_2031
912			\|a GBV_ILN_2034
912			\|a GBV_ILN_2037
912			\|a GBV_ILN_2038
912			\|a GBV_ILN_2039
912			\|a GBV_ILN_2044
912			\|a GBV_ILN_2048
912			\|a GBV_ILN_2049
912			\|a GBV_ILN_2055
912			\|a GBV_ILN_2057
912			\|a GBV_ILN_2059
912			\|a GBV_ILN_2061
912			\|a GBV_ILN_2064
912			\|a GBV_ILN_2065
912			\|a GBV_ILN_2068
912			\|a GBV_ILN_2088
912			\|a GBV_ILN_2093
912			\|a GBV_ILN_2106
912			\|a GBV_ILN_2107
912			\|a GBV_ILN_2108
912			\|a GBV_ILN_2110
912			\|a GBV_ILN_2111
912			\|a GBV_ILN_2112
912			\|a GBV_ILN_2113
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912			\|a GBV_ILN_2148
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912			\|a GBV_ILN_2446
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912			\|a GBV_ILN_4126
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912			\|a GBV_ILN_4249
912			\|a GBV_ILN_4251
912			\|a GBV_ILN_4305
912			\|a GBV_ILN_4306
912			\|a GBV_ILN_4307
912			\|a GBV_ILN_4313
912			\|a GBV_ILN_4322
912			\|a GBV_ILN_4323
912			\|a GBV_ILN_4324
912			\|a GBV_ILN_4325
912			\|a GBV_ILN_4326
912			\|a GBV_ILN_4328
912			\|a GBV_ILN_4333
912			\|a GBV_ILN_4334
912			\|a GBV_ILN_4335
912			\|a GBV_ILN_4336
912			\|a GBV_ILN_4338
912			\|a GBV_ILN_4393
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Implementation of Chromatic Super CAZ/$ AVI^{®} $ medium for active surveillance of ceftazidime-avibactam resistance: preventing the loop from becoming a spiral

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