Multicenter Evaluation of Xpert Carba-R Assay for Detection and Identification of the Carbapenemase Genes in Rectal Swabs and Clinical Isolates

Author(s)

Fred C. Tenover, CepheidFollow
Xi Jin, Hangzhou University
Haomin Zhang, Shanghai Jiaotong University
Shi Wu, Fudan University
Xiaohua Qin, Fudan University
Peiyao Jia, Peking University
Yi-Wei Tang, Cepheid
Min Li, Shanghai Jiaotong University
Fupin Hu, Fudan University
Qiwen Yang, Peking UniversityFollow
Yunsong Yu, Zhejiang University

Document Type

Article

Publication Date

10-14-2020

Publication Source

The Journal of Molecular Diagnostics

Abstract

Rapid detection of carbapenemase-producing organisms is clinically desirable for hospital infection control and antibiotic stewardship. In this multicenter study, the Xpert Carba-R assay was evaluated for detection of the five carbapenemase genes (blaKPC, blaNDM, blaIMP, blaOXA-48, and blaVIM) in 2404 nonduplicate rectal swabs of admitted inpatients and 521 Gram-negative isolates from four tertiary hospitals in China, compared with the reference growth-based method with DNA sequence analysis of colonies. All suspected false-positive results in rectal swabs were resolved by supplementary sequencing from broth cultures. A total of 197 blaKPC, 171 blaNDM, 142 blaIMP, 6 blaVIM, and 5 blaOXA-48 genes were detected by Xpert Carba-R in 417 rectal swabs, with overall positive and negative percentage agreements ranging from 94.5% to 100% and from 94.8% to 99.9%, respectively. Notably, 17.5% (263/1500) of inpatients had rectal colonization with carbapenem-nonsusceptible organisms detected in intensive care units, and 63.1% (166/263) were Xpert Carba-R positive. Among the 469 carbapenem-nonsusceptible and 52 carbapenem-susceptible isolates examined, 373 were Enterobacteriaceae, 55 were Pseudomonas aeruginosa, and 93 were Acinetobacter baumannii. Compared with the reference isolate sequencing, overall positive and negative percentage agreements were 99.7% and 98.0%, respectively. The intra-assay and interassay coefficient of variability values were both

Inclusive pages

111-119

ISBN/ISSN

Print ISSN: 1525-1578; Online ISSN: 1943-7811

Document Version

Postprint

Comments

The accepted manuscript of this publication will be made available in compliance with the publisher’s policy on self-archiving. Permission documentation is on file. Until then, link to the published version using the DOI: https://doi.org/10.1016/j.jmoldx.2020.10.017

Publisher

Elsevier

Volume

23

Peer Reviewed

yes

Issue

1

eCommons Citation

Tenover, Fred C.; Jin, Xi; Zhang, Haomin; Wu, Shi; Qin, Xiaohua; Jia, Peiyao; Tang, Yi-Wei; Li, Min; Hu, Fupin; Yang, Qiwen; and Yu, Yunsong, "Multicenter Evaluation of Xpert Carba-R Assay for Detection and Identification of the Carbapenemase Genes in Rectal Swabs and Clinical Isolates" (2020). Biology Faculty Publications. 363.
https://ecommons.udayton.edu/bio_fac_pub/363