Universität zu Köln

Gill, Christian M., Kresken, Michael, Seifert, Harald and Nicolau, David P. (2021). Evaluation of a Phenotypic Algorithm to Direct Carbapenemase Testing in Pseudomonas aeruginosa: Validation in a Multicenter German Cohort. Microb. Drug Resist., 27 (9). S. 1243 - 1249. NEW ROCHELLE: MARY ANN LIEBERT, INC. ISSN 1931-8448

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Abstract

Pseudomonas aeruginosa remains a prominent nosocomial pathogen. Detection of carbapenemase-producing P. aeruginosa is vital to dictate antimicrobial therapy and infection control measures. A pragmatic, minimum inhibitory concentration-based algorithm using imipenem AND meropenem-resistant plus ceftazidime-, cefepime-, and piperacillin/tazobactam-nonsusceptible criterion was derived to guide carbapenemase testing in P. aeruginosa. This study was an assessment of the algorithm's test performance in a cohort of 985 nonduplicate P. aeruginosa isolates collected from 20 German medical laboratories. Susceptibility data were assessed in the algorithm using both Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) interpretations. Sensitivity and specificity were calculated to evaluate algorithm test performance. The original algorithm criteria resulted in high specificity (95-97%) using both CLSI and EUCAST criteria; however, it failed to capture five carbapenemase-harboring isolates testing piperacillin/tazobactam susceptibility (CLSI/EUCAST). Two carbapenemase-producing isolates were also meropenem susceptible per EUCAST. A modified algorithm utilizing imipenem OR meropenem-resistant plus ceftazidime and cefepime nonsusceptible, improved the sensitivity of the criteria without significantly compromising specificity (CLSI sensitivity/specificity: 96%/94% and EUCAST sensitivity/specificity: 96%/95%). Application of the modified algorithm criteria resulted in high sensitivity and specificity using both CLSI and EUCAST interpretations in a large cohort of clinical P. aeruginosa. Utilization of this algorithm can improve the efficiency of carbapenemase testing in the clinical laboratory.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gill, Christian M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kresken, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Nicolau, David P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-586242
DOI:	10.1089/mdr.2020.0476
Journal or Publication Title:	Microb. Drug Resist.
Volume:	27
Number:	9
Page Range:	S. 1243 - 1249
Date:	2021
Publisher:	MARY ANN LIEBERT, INC
Place of Publication:	NEW ROCHELLE
ISSN:	1931-8448
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SUSCEPTIBLE PSEUDOMONAS Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58624