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Improved blood culture workflow for faster identification of KPC-producing Enterobacterales

Authors
  • Seco, Bruna Mara Silva
  • Campos, Juliana Coutinho
  • da Costa Rocha, Darlan Augusto
  • de Lima, Aline Valerio
  • de Oliveira, Fernanda Filomena
  • Lemo, Mara Elisa Borsato
  • Sampaio, Suely Carlos Ferreira
  • Sampaio, Jorge Luiz Mello
Type
Published Article
Journal
Brazilian Journal of Microbiology
Publisher
Springer International Publishing
Publication Date
Dec 06, 2018
Volume
50
Issue
1
Pages
127–132
Identifiers
DOI: 10.1007/s42770-018-0037-y
Source
Springer Nature
Keywords
License
Yellow

Abstract

Carba-NP original report for blood cultures described the need of subculture and mechanical lysis before testing, reaching the turnaround time of approximately 4 hours for sample preparation. We tested 100 consecutive blood cultures positive for Gram-negative bacilli on the Gram stain from a large clinical laboratory. Bacterial pellets were prepared by centrifugation and submitted to Carba-NP and Blue-Carba tests and used further to prepare smears for Vitek MS. Results obtained with colonies grown on sheep blood agar using the same methodologies were used as the gold standard. Carbapenemase genes were confirmed by PCR and DNA sequencing. Vitek MS identified correctly 86% of the samples. Of note, 7% of the samples were incorrectly reported by the instrument as containing a single isolate. KPC-2 was the predominant carbapenemase detected. There was 100% concordance for both negative and positive results for Carba-NP. In contrast, for Blue-Carba the concordance for positive results was 92.8%, and 41% of strains negative for carbapenemases presented a yellowish color on control well turning the test non-interpretable. The turnaround time for sample preparation for preparing the pellet was 13 min, and no subculture or mechanical lysis is needed when detecting KPC production in Enterobacterales.

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