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CC BY-NC-ND 4.0 · J Lab Physicians 2022; 14(03): 365-368
DOI: 10.1055/s-0042-1744238
Case Report

Molecular Detection of Carbapenemase Enzymes Directly from Positive Blood Cultures Using Xpert Carba-R

Gayatree Nayak
1   Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
,
Bijayini Behera 
1   Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
,
Ashoka Mahapatra
1   Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
,
Swagata Tripathy
2   Department of Anaesthesiology & Critical Care Medicine, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
,
Jyoti Biswal
3   Department of Infection Control Nursing, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
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Abstract

Objective The performance of Xpert Carba-R assay for the direct identification of carbapenemases directly from positive blood culture vials was evaluated.

Materials and Methods In total, 176 positively flagged blood culture vials, yielding carbapenem-resistant GNB (CR-GNB), were enrolled for the detection and differentiation of blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP using Xpert Carba-R.

Results Klebsiella pneumoniae (76/176, 43.1%), Acinetobacter baumannii complex (67/176, 38%), and Escherichia coli (29/176,16.4%) were the predominant isolates. Overall, NDM production was the commonest (61/176, 34.6%), followed by the co-production of NDM + OXA-48 and the absence of any CR gene (44/176, 25%), followed by OXA-48 (27/176, 15.3%). In CR K. pneumoniae, the co-production of NDM + OXA-48 was most frequent (34/76, 44.7%), whereas in the A. baumannii complex, no CR gene was detected in the majority of isolates (38/67, 56.7%). bla NDM was the commonest gene in E. coli (18/29, 62%) and A. baumannii complex (26/67, 38.8%).

Conclusion Xpert Carba-R can identify the molecular mechanism of CR within hours after a blood culture turns positive and, thus, has the potential for optimization of antimicrobial therapy, choosing appropriate novel β-lactam combination agents, as well as infection control interventions.

Keywords

blood culture - carbapenemase - Xpert carba-R

Authors' Contribution

Dr. Gayatree Nayak contributed to acquisition of data, or analysis and interpretation of data, and final approval of the version to be published. Dr. Bijayini Behera contributed to conception and design, acquisition of data, or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, and final approval of the version to be published. Dr. Ashoka Mahapatra contributed to acquisition of data, or analysis and interpretation of data, and final approval of the version to be published. Dr. Swagata Tripathy contributed to conception and design, acquisition of data, and final approval of the version to be published. Mrs. Jyoti Biswal contributed to acquisition of data, and final approval of the version to be published.




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Artikel online veröffentlicht:
19. April 2022

© 2022. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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