Comparison of Two Phenotypic Algorithms To Detect Carbapenemase-Producing Enterobacteriaceae

Area of Science:

• Clinical microbiology
• Antimicrobial resistance
• Diagnostic algorithm development

Background:

• Carbapenemase-producing Enterobacteriaceae (CPE) pose a significant global health threat.
• Accurate and efficient screening methods are crucial for controlling CPE transmission.
• Existing screening algorithms require optimization for improved performance.

Purpose of the Study:

• To evaluate a novel screening algorithm for CPE using faropenem and temocillin disks.
• To compare its performance against the established CA-SFM algorithm.
• To assess its impact on reducing the need for confirmatory testing.

Main Methods:

• A comparative study design was employed.
• The novel algorithm utilized faropenem and temocillin disks for CPE screening.
• Performance was evaluated against the CA-SFM algorithm (ticarcillin-clavulanate, imipenem, temocillin disks).

Main Results:

• Both algorithms demonstrated comparable negative predictive values for CPE screening.
• The faropenem/temocillin algorithm correctly identified 46.2% of OXA-48-like CPE producers.
• This novel algorithm significantly reduced the requirement for complementary tests (42.2% vs. 62.6%).

Conclusions:

• The faropenem/temocillin disk-based algorithm is a promising tool for CPE screening.
• It offers a more efficient approach by decreasing the need for further laboratory investigations.
• This method aids in the timely identification of specific CPE types, such as OXA-48-like producers.