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Evaluation of a new chromogenic medium, chromID OXA-48, for recovery of carbapenemase-producing Enterobacteriaceae from patients at a university hospital in Turkey

Lookup NU author(s): Dr Clare Lanyon, Dr John Perry

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Abstract

The purpose of this study was to evaluate a new chromogenic medium, chromID OXA-48, for the isolation of carbapenemase-producing Enterobacteriaceae (CPE) directly from rectal swabs. chromID CARBA and chromID OXA-48 are two chromogenic media that have been commercialized for the isolation of CPE directly from clinical samples. Both media were evaluated alongside a broth enrichment method recommended by the CDC for isolation of CPE, with rectal swabs from 302 unique hospitalized patients at the Hacettepe University Hospital, Ankara, Turkey. A total of 33 patients (11 %) were found to be colonized with CPE using a combination of all methods, and all CPE produced OXA-48 carbapenemase. Klebsiella pneumoniae was by far the most dominant species of CPE and was isolated from 31 patients. Culture on chromID OXA-48 offered the highest sensitivity (75.8 %) for detection of CPE compared with the other two methods (sensitivity for both other methods was 57.6 %) and also offered the highest specificity (99.3 %). However, a combination of methods (either chromID OXA-48 plus CDC method or chromID OXA-48 plus chromID CARBA) was necessary to achieve an acceptable sensitivity (90.9 %). For isolation of CPE, in a setting where OXA-48 carbapenemase is the dominant type of carbapenemase, chromID OXA-48 is a highly useful medium but using a combination of methods is optimal for adequate detection. The combined use of two chromogenic media offered acceptable sensitivity (90.9 %) and the highest specificity (98.5 %) and also allowed for isolation of CPE within 18-20 h.

Publication metadata

Author(s): Zarakolu P, Day KM, Sidjabat HE, Kamolvit W, Lanyon CV, Cummings SP, Paterson DL, Akova M, Perry JD

Publication type: Article

Publication status: Published

Journal: European Journal of Clinical Microbiology & Infectious Diseases

Year: 2015

Volume: 34

Issue: 3

Pages: 519-525

Print publication date: 01/03/2015

Online publication date: 12/10/2014

Acceptance date: 19/09/2014

ISSN (print): 0934-9723

ISSN (electronic): 1435-4373

Publisher: Springer

URL: http://dx.doi.org/10.1007/s10096-014-2255-z

DOI: 10.1007/s10096-014-2255-z

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