Contribution and limits of clinical specimens for the screening of intestinal multi-drug-resistant bacteria in view of laboratory automation

A Geraud de Galassus; F Cizeau; A Agathine; C Domrane; D Ducellier; V Fihman; J-W Decousser

doi:10.1016/j.jhin.2017.06.001

Contribution and limits of clinical specimens for the screening of intestinal multi-drug-resistant bacteria in view of laboratory automation

J Hosp Infect. 2017 Sep;97(1):59-63. doi: 10.1016/j.jhin.2017.06.001. Epub 2017 Jun 6.

Authors

A Geraud de Galassus¹, F Cizeau¹, A Agathine¹, C Domrane¹, D Ducellier¹, V Fihman¹, J-W Decousser²

Affiliations

¹ Laboratory of Bacteriology and Infection Control, Department of Microbiology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France.
² Laboratory of Bacteriology and Infection Control, Department of Microbiology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France; University Paris East Créteil, Créteil, France. Electronic address: jean-winoc.decousser@aphp.fr.

PMID: 28600076
DOI: 10.1016/j.jhin.2017.06.001

Abstract

The detection of multi-drug-resistant bacteria carriers constitutes a race against time for infection preventionists. Alongside standard analysis for diagnostic purposes and a rectal screening strategy, the authors tested a heavy-loaded selective method against 562 clinical specimens from 439 patients to detect extended-spectrum beta-lactamase-producing (ESBL) or carbapenemase-producing Enterobacteriaceae (CPE) and vancomycin-resistant enterococci (VRE). The approach identified five more specimens positive for ESBL-producing Enterobacteriaceae than standard analysis, and six out of nine known VRE/CPE carriers (three new CPE/VRE strains were also identified in this cohort). In view of the ongoing automation of laboratories, this approach focusing on urine and stool specimens may be an alternative or complementary approach to dedicated rectal screening.

Keywords: CPE; Carriage; Clinical specimen; Diagnosis; ESBL; Laboratory; Screening; VRE.

MeSH terms

Automation, Laboratory / methods*
Bacterial Infections / diagnosis*
Bacterial Infections / microbiology
Bacteriological Techniques / methods*
Carrier State / diagnosis*
Carrier State / microbiology
Drug Resistance, Multiple, Bacterial*
Enterobacteriaceae / drug effects
Enterobacteriaceae / isolation & purification*
Humans
Mass Screening / methods
Specimen Handling / methods
Vancomycin-Resistant Enterococci / drug effects
Vancomycin-Resistant Enterococci / isolation & purification*