Abstract
Chromogenic chromID® CARBA medium was compared with CDC method and MacConkey agar with imipenem for its performance in detecting carbapenemase-producing Enterobacteriaceae (CPE) during a faecal screening surveillance program. Double rectal swabs were collected from patients hospitalized in the ICU. One swab was inoculated onto the solid media chromID® CARBA and MacConkey agar with imipenem, while the other was tested according to CDC protocol. Suspected colonies from all procedures were identified to species level and tested for their susceptibility to carbapenems by phenotypic tests. All carbapenem non-susceptible isolates were tested by the modified Hodge test (MHT) and synergy tests. Positive results were confirmed by PCR testing for carbapenemase gene detection. Performance of all three procedures applied was statistically analyzed as compared to MHT and PCR results for the presence of carbapenemase-encoding genes. Out of 177 rectal samples tested, 86 samples were found to contain one or more CPE verified by molecular detection of carbapenemase encoding genes among isolated Enterobacteriaceae. Sensitivity of chromID® CARBA was 96.5 % in clinical samples. Specificity was 91.2 % at the reading level and 100.0 % after Gram staining. chromID® CARBA performed with high accuracy among the phenotypic methods applied, giving early results.
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Ethical approval
The study was carried out under the permission of the University Hospital Ethical Committee (No. 571).
Funding
This work was supported by bioMérieux SA (evaluation protocol reference Number 43861).
Authorship/contribution
M.P.O. collected the samples, performed the susceptibility tests and wrote the manuscript. C.B. identified bacteria to species level, kept frozen the isolates and reviewed the paper. M.C. collected data, supervised all phenotypes and genotypes and reviewed the manuscript. N.B. performed the PCRs and reviewed the manuscript. J.H. and G.Z. designed the study protocol, collected the data, performed part of the statistical analysis and reviewed the article. I.S. reviewed and took part in designing the study protocol, supervised all experiments, collection of data and wrote the article.
Conflict of interest
M.P.O and C.B. were financially supported by the funding of bioMérieux SA (evaluation protocol reference number 43861) to the University of Patras. N.B., J.H. and G.Z. work at bioMérieux SA, Marcy L’Etoile, France.
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Papadimitriou-Olivgeris, M., Bartzavali, C., Christofidou, M. et al. Performance of chromID® CARBA medium for carbapenemases-producing enterobacteriaceae detection during rectal screening. Eur J Clin Microbiol Infect Dis 33, 35–40 (2014). https://doi.org/10.1007/s10096-013-1925-6
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DOI: https://doi.org/10.1007/s10096-013-1925-6