Comparison of the Clinical Outcomes of Patients with Positive Xpert Carba-R Tests for Carbapenemase-Producing Enterobacterales According to Culture Positivity
Open Forum Infectious Diseases, ISSN: 2328-8957, Vol: 9, Issue: 1, Page: ofab594
2022
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Article Description
Background: We aimed to compare the clinical outcomes of patients with positive Xpert Carba-R assay results for carbapenemase-producing Enterobacterales (CPE) according to CPE culture positivity. Methods: We retrospectively collected data for patients with positive CPE (positive Xpert Carba-R or culture) who underwent both tests from August 2018 to March 2021 in a 2700-bed tertiary referral hospital in Seoul, South Korea. We compared the clinical outcomes of patients positive for Xpert Carba-R according to whether they were positive (XPCP) or negative (XPCN) for CPE culture. Results: Of 322 patients with CPE who underwent both Xpert Carba-R and culture, 313 (97%) were positive for Xpert Carba-R for CPE. Of these, 87 (28%) were XPCN, and 226 (72%) were XPCP. XPCN patients were less likely to have a history of previous antibiotic use (75.9% vs 90.3%; P = .001) and to have Klebsiella pneumoniae carbapenemase (21.8% vs 48.9%; P < .001). None of the XPCN patients developed infection from colonization within 6 months, whereas 13.4% (29/216) of the XPCP patients did (P < .001). XPCN patients had lower transmission rates than XPCP patients (3.0% [9/305] vs 6.3% [37/592]; P = .03). There was no significant difference in CPE clearance from positive culture results between XPCN and XPCP patients (40.0% [8/20] vs 26.7% [55/206]; P = .21). Conclusions: Our study suggests that XPCN patients had lower rates of both infection and transmission than XPCP patients. The Xpert Carba-R assay is clinically useful not only for rapid identification of CPE but also for predicting risks of infection and transmission when performed along with culture.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85124887396&origin=inward; http://dx.doi.org/10.1093/ofid/ofab594; http://www.ncbi.nlm.nih.gov/pubmed/35036462; https://academic.oup.com/ofid/article/doi/10.1093/ofid/ofab594/6502311; https://dx.doi.org/10.1093/ofid/ofab594; https://academic.oup.com/ofid/article/9/1/ofab594/6502311
Oxford University Press (OUP)
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