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Rectal screening for carbapenemase-producing Enterobacteriaceae: a proposed workflow
Claudio Foschi1, Paolo Gaibani2, Donatella Lombardo2
1Microbiology Unit, DIMES, University of Bologna, via Massarenti 9, Bologna, Italy; Microbiology Unit, S. Orsola-Malpighi Hospital, Via Massarenti 9, Bologna, Italy.
Journal of Global Antimicrobial Resistance
|October 23, 2019
Summary
This study introduces a rapid culture-based protocol for screening carbapenemase-producing Enterobacteriaceae (CPE) in rectal swabs. The new method accurately identifies CPE and carbapenemase types, improving healthcare infection control.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Healthcare Epidemiology
Background:
- Active surveillance for carbapenemase-producing Enterobacteriaceae (CPE) is essential to prevent transmission in healthcare settings.
- Current screening methods can be time-consuming, potentially delaying infection control measures.
Purpose of the Study:
- To develop and evaluate a novel culture-based protocol for rectal swab screening of CPE.
- To combine CPE detection with rapid carbapenemase typing for enhanced diagnostics.
Main Methods:
- Integration of automated digital analysis of selective chromogenic media (WASPLab®) with rapid carbapenemase confirmation tests (MALDI-TOF/MS or immunochromatographic assay).
- Analysis of 21,162 rectal swabs for CPE screening at a major Italian hospital.
Main Results:
- WASPLab Image Analysis Software demonstrated 100% sensitivity and 79.4% specificity in segregating plates.
- The protocol identified CPE in 76.9% of positive bacterial cultures, with rapid carbapenemase typing.
- Mean turnaround time was significantly reduced to 18–24 hours compared to manual methods.
Conclusions:
- The proposed workflow is fast, reliable, and efficient for CPE screening.
- This method is particularly beneficial for high-throughput laboratories and regions with endemic KPC-producing Klebsiella pneumoniae.
