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dc.contributor.authorJosa, Diego Fernando
dc.contributor.authorBustos, Ingrid Gisell
dc.contributor.authorYusef, Soad Amira
dc.contributor.authorLópez, Natalia|Reyes, |Luis Felipe
dc.date.accessioned2023-08-16T19:16:43Z
dc.date.available2023-08-16T19:16:43Z
dc.date.issued2022
dc.identifier.citationJosa, D., Bustos, G., Yusef, S., Crevoisier S. (2022). Rapid Detection of Carbapenemase and Extended-Spectrum ß-Lactamase Producing Gram-Negative Bacteria Directly from Positive Blood Cultures Using a Novel Protocol, antibiotics, 12(34),1-11es_CO
dc.identifier.issn20796382
dc.identifier.otherhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85146780440&doi=10.3390%2fantibiotics12010034&partnerID=40&md5=9efd9a41ba6e14a5c6bd81417d89023b
dc.identifier.urihttp://hdl.handle.net/10818/56320
dc.description6 páginas
dc.description.abstractBackground: Early and adequate antibiotic treatment is the cornerstone of improving clinical outcomes in patients with bloodstream infections (BSI). Delays in appropriate antimicrobial therapy have catastrophic consequences for patients with BSI. Microbiological characterization of multi-drug resistant pathogens (MDRP) allows clinicians to provide appropriate treatments. Current microbiologic techniques may take up to 96 h to identify causative pathogens and their resistant patterns. Therefore, there is an important need to develop rapid diagnostic strategies for MDRP. We tested a modified protocol to detect carbapenemase and extended-spectrum β-lactamase (ESBL) producing Gram-negative bacteria (GNB) from positive blood cultures. Methods: This is a prospective cohort study of consecutive patients with bacteremia. We developed a modified protocol using the HB&L® system to detect MDRP. The operational characteristics were analyzed for each test (HB&L-ESBL/AmpC® and HB&L-Carbapenemase® kits). The kappa coefficient, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratios (LR) with 95% confidence intervals (CI), and reduction in identification time of this novel method were calculated. Results: Ninety-six patients with BSI were included in the study. A total of 161 positive blood cultures were analyzed. Escherichia coli (50%, 81/161) was the most frequently identified pathogen, followed by Klebsiella pneumoniae (15%, 24/161) and Pseudomonas aeruginosa (8%, 13/161). Thirty-three percent of isolations had usual resistance patterns. However, 34/161 (21%) of identified pathogens were producers of carbapenemases and 21/161 (13%) of extended-spectrum β-lactamases. Concordance between our HB&L® modified protocol and the traditional method was 99% (159/161). Finally, identification times were significantly shorter using our HB&L®-modified protocol than traditional methods: median (IQR) 19 h (18, 22) vs. 61 h (60, 64), p < 0.001. Conclusions: Here, we provide novel evidence that using our HB&L®-modified protocol is an effective strategy to reduce the time to detect MDRP producers of carbapenemases or extended-spectrum β-lactamases, with an excellent concordance rate when compared to the gold standard. Further studies are needed to confirm these findings and to determine whether this method may improve clinical outcomes.en
dc.language.isoenges_CO
dc.publisherAntibioticses_CO
dc.relation.ispartofseriesAntibiotics 2023, 12(1), 34
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.sourceUniversidad de La Sabanaes_CO
dc.sourceIntellectum Repositorio Universidad de La Sabanaes_CO
dc.subject.otherBlood culturesen
dc.subject.otherRapid diagnostic testen
dc.subject.otherBloodstream infectionen
dc.subject.otherCarbapenemasesen
dc.subject.otherExtended-spectrum β-lactamase (ESBL)en
dc.subject.otherNephelometryen
dc.titleRapid Detection of Carbapenemase and Extended-Spectrum β-Lactamase Producing Gram-Negative Bacteria Directly from Positive Blood Cultures Using a Novel Protocolen
dc.typejournal articlees_CO
dc.type.hasVersionpublishedVersiones_CO
dc.rights.accessRightsopenAccesses_CO
dc.identifier.doi10.3390/antibiotics12010034


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