Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae
Preventing transmission of carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE) is a public health priority. A phenotype-based definition that reliably identifies CP-CRE while minimizing misclassification of non–CP-CRE could help prevention efforts. To assess possible definition...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Centers for Disease Control and Prevention
2015-09-01
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| Series: | Emerging Infectious Diseases |
| Subjects: | |
| Online Access: | https://wwwnc.cdc.gov/eid/article/21/9/15-0198_article |
| _version_ | 1818159068707028992 |
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| author | Nora Chea Sandra N. Bulens Thiphasone Kongphet-Tran Ruth Lynfield Kristin Shaw Paula Snippes Vagnone Marion Kainer Daniel Muleta Lucy Wilson Elisabeth Vaeth Ghinwa Dumyati Cathleen Concannon Erin C. Phipps Karissa Culbreath Sarah J. Janelle Wendy Bamberg Alice Y. Guh Brandi M. Limbago Alexander J. Kallen |
| author_facet | Nora Chea Sandra N. Bulens Thiphasone Kongphet-Tran Ruth Lynfield Kristin Shaw Paula Snippes Vagnone Marion Kainer Daniel Muleta Lucy Wilson Elisabeth Vaeth Ghinwa Dumyati Cathleen Concannon Erin C. Phipps Karissa Culbreath Sarah J. Janelle Wendy Bamberg Alice Y. Guh Brandi M. Limbago Alexander J. Kallen |
| author_sort | Nora Chea |
| collection | DOAJ |
| description | Preventing transmission of carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE) is a public health priority. A phenotype-based definition that reliably identifies CP-CRE while minimizing misclassification of non–CP-CRE could help prevention efforts. To assess possible definitions, we evaluated enterobacterial isolates that had been tested and deemed nonsusceptible to >1 carbapenem at US Emerging Infections Program sites. We determined the number of non-CP isolates that met (false positives) and CP isolates that did not meet (false negatives) the Centers for Disease Control and Prevention CRE definition in use during our study: 30% (94/312) of CRE had carbapenemase genes, and 21% (14/67) of Klebsiella pneumoniae carbapenemase–producing Klebsiella isolates had been misclassified as non-CP. A new definition requiring resistance to 1 carbapenem rarely missed CP strains, but 55% of results were false positive; adding the modified Hodge test to the definition decreased false positives to 12%. This definition should be considered for use in carbapenemase-producing CRE surveillance and prevention. |
| first_indexed | 2024-12-11T15:40:06Z |
| format | Article |
| id | doaj.art-66c25b318f1d4f05976ed0992aff037d |
| institution | Directory Open Access Journal |
| issn | 1080-6040 1080-6059 |
| language | English |
| last_indexed | 2024-12-11T15:40:06Z |
| publishDate | 2015-09-01 |
| publisher | Centers for Disease Control and Prevention |
| record_format | Article |
| series | Emerging Infectious Diseases |
| spelling | doaj.art-66c25b318f1d4f05976ed0992aff037d2022-12-22T00:59:50ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592015-09-012191611161610.3201/eid2109.150198Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant EnterobacteriaceaeNora CheaSandra N. BulensThiphasone Kongphet-TranRuth LynfieldKristin ShawPaula Snippes VagnoneMarion KainerDaniel MuletaLucy WilsonElisabeth VaethGhinwa DumyatiCathleen ConcannonErin C. PhippsKarissa CulbreathSarah J. JanelleWendy BambergAlice Y. GuhBrandi M. LimbagoAlexander J. KallenPreventing transmission of carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE) is a public health priority. A phenotype-based definition that reliably identifies CP-CRE while minimizing misclassification of non–CP-CRE could help prevention efforts. To assess possible definitions, we evaluated enterobacterial isolates that had been tested and deemed nonsusceptible to >1 carbapenem at US Emerging Infections Program sites. We determined the number of non-CP isolates that met (false positives) and CP isolates that did not meet (false negatives) the Centers for Disease Control and Prevention CRE definition in use during our study: 30% (94/312) of CRE had carbapenemase genes, and 21% (14/67) of Klebsiella pneumoniae carbapenemase–producing Klebsiella isolates had been misclassified as non-CP. A new definition requiring resistance to 1 carbapenem rarely missed CP strains, but 55% of results were false positive; adding the modified Hodge test to the definition decreased false positives to 12%. This definition should be considered for use in carbapenemase-producing CRE surveillance and prevention.https://wwwnc.cdc.gov/eid/article/21/9/15-0198_articlecarbapenemasecarbapenem-resistantcarbapenemase producersEnterobacteriaceaeCREenterobacteria |
| spellingShingle | Nora Chea Sandra N. Bulens Thiphasone Kongphet-Tran Ruth Lynfield Kristin Shaw Paula Snippes Vagnone Marion Kainer Daniel Muleta Lucy Wilson Elisabeth Vaeth Ghinwa Dumyati Cathleen Concannon Erin C. Phipps Karissa Culbreath Sarah J. Janelle Wendy Bamberg Alice Y. Guh Brandi M. Limbago Alexander J. Kallen Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae Emerging Infectious Diseases carbapenemase carbapenem-resistant carbapenemase producers Enterobacteriaceae CRE enterobacteria |
| title | Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae |
| title_full | Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae |
| title_fullStr | Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae |
| title_full_unstemmed | Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae |
| title_short | Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae |
| title_sort | improved phenotype based definition for identifying carbapenemase producers among carbapenem resistant enterobacteriaceae |
| topic | carbapenemase carbapenem-resistant carbapenemase producers Enterobacteriaceae CRE enterobacteria |
| url | https://wwwnc.cdc.gov/eid/article/21/9/15-0198_article |
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