Impact of the blue-carba rapid test for carbapenemase detection on turnaround time for an early therapy against Pseudomonas aeruginosa.
Am J Infect Control
; 49(3): 352-354, 2021 03.
Article
em En
| MEDLINE
| ID: mdl-32814073
BACKGROUND: To determine the turnaround time from a blue-carba result until a final microbiological report (bacterial identification plus antimicrobial susceptibility profile) and to infer the impact of an early therapeutic intervention based on the blue-carba results. METHODS: Pseudomonas aeruginosa isolates were recovered from hospitalized patients from Porto Alegre, Brazil, and tested by blue-carba test. Time required for a blue-carba result, right after the sample processing, was compared with those required to get final report (specie identification and antimicrobial susceptibility profile) Isolates blue-carba positive were tested by phenotypically and genotypically for Klebsiella pneumoniae carbapenemase and metallo-ß-lactamase genes. RESULTS: A total of 199 isolates were analyzed and 23 (11.6%) were blue-carba positive and harboring the blaSPM-1-like gene. Fifty-two (26.1%) isolates were blue-carba negative but resistant to meropenem and/or imipenem. Polymyxin B and ceftolozane/tazobactam (this latter except for SPM-1 producers) were 100% active for all P. aeruginosa isolates, a blue-carba test allow an earlier intervention or adequacy of therapy. CONCLUSIONS: Early adequacy can be promoted by blue-carba test for 11.6% of SPM-1-producing P. aeruginosa isolates, polymyxin B could be prior associated and ceftolozane/tazobactam withdrawn from therapy. For the remaining isolates, empirical therapy involving ceftolozane/tazobactam can be maintained with greater likelihood of adequacy. An active communication between laboratory and clinical services is necessary to better explore these earlier blue-carba results, significantly reducing the time for a first intervention.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pseudomonas aeruginosa
/
Infecções por Pseudomonas
Tipo de estudo:
Diagnostic_studies
Limite:
Humans
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Am J Infect Control
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Estados Unidos