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- Title
Comparison of nine different selective agars for the detection of carbapenemase-producing Enterobacterales (CPE).
- Authors
Göttig, Stephan; Walker, Sarah V.; Saleh, Ahmad; Koroska, Florian; Sommer, Julian; Stelzer, Yvonne; Steinmann, Joerg; Hamprecht, Axel
- Abstract
The rapid identification of patients colonized with carbapenem-resistant Enterobacterales (CRE) is important for infection control purposes. Here, we compared and evaluated nine different agars for the detection of carbapenemase-producing Enterobacterales (CPE) from clinical samples. In the study, 69 CPE and 40 carbapenemase-negative isolates were included. Overall, seven commercially available screening agars were assessed: Brilliance CRE (Oxoid), Chromatic CRE (Liofilchem), chromID CARBA and chromID OXA-48 (both bioMérieux), three ESBL agars (Chromatic ESBL [Liofilchem], chromID ESBL [bioMérieux], Brilliance ESBL [Oxoid]), and two agars produced in-house (McCARB and McCARB-T). The sensitivity of CRE agars for CPE detection ranged from 34.8 to 98.6%. Brilliance CRE and McCARB/McCARB-T showed the overall highest sensitivity (98.6 and 97.1%, respectively). OXA-48 producers were the most difficult to detect; only 4/9 agars detected all isolates (McCARB/McCARB-T, Chromatic CRE, ChromID OXA-48). Additionally, all ESBL-negative OXA-48 isolates failed to grow on ESBL screening agars. Specificity ranged from 30 (Brilliance ESBL) to 100% (ChromID OXA-48). The limit of detection for different CPE in spiked stool samples ranged from 1.5 × 101 to 1.5 × 103 CFU/ml. Overall, Brilliance CRE and the McCARB in-house agars showed the best performance and were able to detect most CPE, including almost all OXA-48. ESBL agars were not suitable for detection of CPE alone, as OXA-48 isolates negative for ESBL were suppressed. The highest sensitivity was achieved by a combination of a CRE agar and an ESBL agar.
- Subjects
AGAR; DETECTION limit; AGAR plates
- Publication
European Journal of Clinical Microbiology & Infectious Diseases, 2020, Vol 39, Issue 5, p923
- ISSN
0934-9723
- Publication type
Article
- DOI
10.1007/s10096-019-03786-7