Performance of the EUCAST disc diffusion method and tw MIC methods in detection of Enterobacteriaceae with reduced susceptibility to meropenem : the NordicAST CPE study

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NordicAST CPE Study Grp , Haldorsen , B & Kärpänoja , P 2018 , ' Performance of the EUCAST disc diffusion method and tw MIC methods in detection of Enterobacteriaceae with reduced susceptibility to meropenem : the NordicAST CPE study ' , Journal of Antimicrobial Chemotherapy , vol. 73 , no. 10 , pp. 2738-2747 . https://doi.org/10.1093/jac/dky276

Title: Performance of the EUCAST disc diffusion method and tw MIC methods in detection of Enterobacteriaceae with reduced susceptibility to meropenem : the NordicAST CPE study
Author: NordicAST CPE Study Grp; Haldorsen, Bjorg; Kärpänoja, Pauliina
Contributor: University of Helsinki, HYKS erva
Date: 2018-10
Language: eng
Number of pages: 10
Belongs to series: Journal of Antimicrobial Chemotherapy
ISSN: 0305-7453
URI: http://hdl.handle.net/10138/299121
Abstract: Objectives: To examine performance of EUCAST disc diffusion and supplementary MIC methods for detection of Enterobacteriaceae with reduced susceptibility to meropenem using EUCAST screening recommendations. Methods: Sixty-one Nordic laboratories delivered data on EUCAST disc diffusion (n = 61), semi-automated meropenem MIC (n = 23; VITEK2, n = 20 and Phoenix, n = 3) and gradient meropenem MIC (n = 58) methods: The strains (n - 27) included the major carbapenemase classes (A, n - 4; B, n - 9; D, n - 6) involved in the global spread of carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE strains (n = 8) covering a range of broth microdilution (BMD) meropenem MICs. Results: A triplicate Klebsiella vanicola (meropenem MIC >= 0,5 mg/L) harbouring OXA-48 and Escherichia coli ATCC 25922 showed an overall good precision. Meropenem zone diameters below the EUCAST screening cut-off (= 1 mg/L (n = 21), irrespective of resistance mechanism. For three strains (MIC - 0.5 mg/L) with OXA-481-181, eight laboratories provided meropenem zone diameters above the screening cut-off, Very major errors (VMEs) were not observed. The overall distributions of major errors (MEs) and minor errors (mEs) were 9% and 36% (disc diffusion), 26% and 18% (VITEK2) and 7% and 20% (gradient MIC), respectively, Differences in ME and mE distributions between disc diffusion and MIC gradient tests compared with semi-automated methods were significant (P <0,0001), using BMD MICs as a reference for categorization, Conclusions: The EUCAST disc diffusion method is a robust method to screen for CPE but isolates with meropenem MICs
Subject: CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE
D BETA-LACTAMASE
KLEBSIELLA-PNEUMONIAE
PREVALENCE
RESISTANCE
EVOLUTION
SPREAD
3121 General medicine, internal medicine and other clinical medicine
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