Document Type
Article
Publication Date
2-14-2023
Publication Source
Emerging Microbes & Infections
Abstract
Molecular carbapenem-resistance testing, such as for the presence of carbapenemases genes, is commonly implemented for the detection of carbapenemase-producing Enterobacterales. Carbapenemase-producing P. aeruginosa is also associated with significant morbidity and mortality, although; prevalence may be underappreciated in the United States due to a lack of carbapenemase testing. The present study sought to compare hands-on time, cost and workflow implementation of carbapenemase gene testing in Enterobacterales and P. aeruginosa isolates versus sending out isolates to a public health laboratory (PHL) for testing to assess if in-house can provide actionable results. The time to carbapenemase gene results were compared. Differences in cost for infection prevention measures were extrapolated from the time of positive carbapenemase gene detection in-house versus PHL. The median time to perform carbapenemase gene testing was 7.5 min (range 5–14) versus 10 min (range 8–22) for preparation to send isolates to the PHL. In-house testing produced same day results compared with a median of 6 days (range 3–14) to receive results from PHL. Cost of in-house testing and send outs were similar ($46.92 versus $40.53, respectively). If contact precautions for patients are implemented until carbapenemase genes are ruled out, in-house testing can save an estimated $76,836.60 annually. Extension of in-house carbapenemase testing to include P. aeruginosa provides actionable results 3–14 days earlier than PHL Standard Pathway testing, facilitating guided therapeutic decisions and infection prevention measures. Supplemental phenotypic algorithms can be implemented to curb the cost of P. aeruginosa carbapenemases testing by identifying isolates most likely to harbour carbapenemases.
ISBN/ISSN
Online ISSN: 2222-1751
Document Version
Published Version
Publisher
Taylor & Francis
Volume
12
Peer Reviewed
yes
Issue
1
Keywords
Carbapenemase, P. aeruginosa, Enterobacterales, workflow, rapid diagnostics testing
Sponsoring Agency
This study was funded by Cepheid, Sunnyvale, CA through an investigator initiated grant.
eCommons Citation
Tenover, Fred C.; Gill, Christian M.; Rajkotia, Poonam; Roberts, Amity L.; and Nicolau, David P., "Directed Carbapenemase Testing Is No Longer Just for Enterobacterales: Cost, Labor, and Workflow Assessment of Expanding Carbapenemase Testing to Carbapenem-Resistant P. aeruginosa" (2023). Biology Faculty Publications. 351.
https://ecommons.udayton.edu/bio_fac_pub/351
Included in
Biology Commons, Biotechnology Commons, Cell Biology Commons, Genetics Commons, Microbiology Commons, Molecular Genetics Commons
Comments
This document is made available for download in compliance with the publisher’s open-access policy. Permission documentation is on file.