Universität zu Köln

Gill, Christian M., Aktap, Elif, Alfouzan, Wadha, Bourassa, Lori, Brink, Adrian, Burnham, Carey-Ann D., Canton, Rafael, Carmeli, Yehuda, Falcone, Marco, Kiffer, Carlos ORCID: 0000-0003-1122-0693, Marchese, Anna ORCID: 0000-0002-3188-3518, Martinez, Octavio, Pournaras, Spyros, Satlin, Michael J., Seifert, Harald, Thabit, Abrar K., Thomson, Kenneth S., Virginia Villegas, Maria and Nicolau, David P. (2022). Multicenter, Prospective Validation of a Phenotypic Algorithm to Guide Carbapenemase Testing in Carbapenem-Resistant Pseudomonas aeruginosa Using the ERACE-PA Global Surveillance Program. Open Forum Infect. Dis., 9 (2). CARY: OXFORD UNIV PRESS INC. ISSN 2328-8957

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Abstract

Background Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) is a global challenge. However, detection efforts can be laborious because numerous mechanisms produce carbapenem resistance. A minimum inhibitory concentration-based algorithm (imipenem- or meropenem-resistant plus ceftazidime-nonsusceptible plus cefepime-nonsusceptible) was proposed to identify the isolates most likely to harbor a carbapenemase; however, prospective validation in geographies displaying genotypic diversity and varied carbapenemase prevalence is warranted. Methods CRPA isolates were collected during the Enhancing Rational Antimicrobials for P. aeruginosa (ERACE-PA) global surveillance program from 17 sites in 12 countries. Isolates underwent susceptibility testing following local standards to ceftazidime, cefepime, and ceftolozane/tazobactam. Isolates underwent initial phenotypic carbapenemase screening followed by molecular testing if positive. The primary algorithm criteria were applied, and results were compared with phenotypic carbapenemase results to assess the performance of the algorithm. A secondary criterion, the algorithm criterion or imipenem- or meropenem-resistant plus ceftolozane/tazobactam-nonsusceptible, was assessed. Results A total of 807 CRPA were assessed, and 464 isolates met the algorithm criteria described above. Overall, testing was reduced by 43% compared with testing all CRPA. Carbapenemase-positive isolates missed by the algorithm were largely driven by Guiana extended spectrum (GES). Addition of the criterion of imipenem- or meropenem-resistant plus ceftolozane/tazobactam-nonsusceptible decreased the number of CP-CRPA missed by the algorithm (21 vs 40 isolates, respectively), reducing number of isolates tested by 39%. Conclusions Application of the initial algorithm (imipenem- or meropenem-resistant plus ceftazidime-nonsusceptible plus cefepime-nonsusceptible) performed well in a global cohort, with 33% phenotypically carbapenemase-positive isolates. The addition of imipenem- or meropenem-resistant plus ceftolozane/tazobactam-nonsusceptible reduced the number of phenotypically carbapenemase-positive isolates missed and may be useful in areas with a prominence of GES.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gill, Christian M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Aktap, Elif UNSPECIFIED UNSPECIFIED UNSPECIFIED Alfouzan, Wadha UNSPECIFIED UNSPECIFIED UNSPECIFIED Bourassa, Lori UNSPECIFIED UNSPECIFIED UNSPECIFIED Brink, Adrian UNSPECIFIED UNSPECIFIED UNSPECIFIED Burnham, Carey-Ann D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Canton, Rafael UNSPECIFIED UNSPECIFIED UNSPECIFIED Carmeli, Yehuda UNSPECIFIED UNSPECIFIED UNSPECIFIED Falcone, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Kiffer, Carlos UNSPECIFIED orcid.org/0000-0003-1122-0693 UNSPECIFIED Marchese, Anna UNSPECIFIED orcid.org/0000-0002-3188-3518 UNSPECIFIED Martinez, Octavio UNSPECIFIED UNSPECIFIED UNSPECIFIED Pournaras, Spyros UNSPECIFIED UNSPECIFIED UNSPECIFIED Satlin, Michael J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Thabit, Abrar K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Thomson, Kenneth S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Virginia Villegas, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Nicolau, David P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-697134
DOI:	10.1093/ofid/ofab617
Journal or Publication Title:	Open Forum Infect. Dis.
Volume:	9
Number:	2
Date:	2022
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	2328-8957
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Immunology; Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69713