Performance of the Check-Direct ESBL Screen for BD MAXTM for detection of asymptomatic faecal carriage of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae

Kirsi Gröndahl-Yli-Hannuksela; Emilia Lönnqvist; Harri Marttila; Esa Rintala; Kaisu Rantakokko-Jalava; Jaana Vuopio

doi:10.1016/j.jgar.2020.04.015

Performance of the Check-Direct ESBL Screen for BD MAX^TM for detection of asymptomatic faecal carriage of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae

J Glob Antimicrob Resist. 2020 Sep:22:408-413. doi: 10.1016/j.jgar.2020.04.015. Epub 2020 Apr 26.

Authors

Kirsi Gröndahl-Yli-Hannuksela¹, Emilia Lönnqvist², Harri Marttila³, Esa Rintala³, Kaisu Rantakokko-Jalava⁴, Jaana Vuopio⁵

Affiliations

¹ University of Turku, Institute of Biomedicine, Kiinamyllynkatu 10, 20520 Turku, Finland. Electronic address: kagron@utu.fi.
² University of Turku, Institute of Biomedicine, Kiinamyllynkatu 10, 20520 Turku, Finland.
³ Turku University Hospital, Department of Hospital Hygiene & Infection Control, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
⁴ Turku University Hospital, Clinical Microbiology Laboratory, Kiinamyllynkatu 10, 20520 Turku, Finland.
⁵ University of Turku, Institute of Biomedicine, Kiinamyllynkatu 10, 20520 Turku, Finland; Turku University Hospital, Clinical Microbiology Laboratory, Kiinamyllynkatu 10, 20520 Turku, Finland.

PMID: 32348901
DOI: 10.1016/j.jgar.2020.04.015

Abstract

Objectives: Accurte diagnostic methods are crucial for the detection of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E). Besides culture-based gold-standard methods, new molecular gene detection tests are reaching the market. The aim of this study was to investigate the performance of the direct quantitative PCR (qPCR)-based methods Check-Direct ESBL and CPE Screen for BD MAX^TM in relation to traditional culture-based methods for detection of ESBL-E faecal carriage.

Methods: Faecal samples were collected from healthy adult volunteers. Samples were cultured on chromogenic ESBL agar plates and were screened for ESBL-producing Escherichia coli and Klebsiella pneumoniae. Confirmed ESBL- and AmpC-producing isolates were further analysed using whole-genome sequencing. In addition, faecal samples were analysed using Check-Direct ESBL and CPE Screen for BD MAX^TM and the results were compared with the gold-standard culture-based method.

Results: Of 176 faecal samples examined, 11 (6.3%) grew ESBL-producing E. coli or K. pneumoniae isolates. Among 173 analysed samples, Check-Direct ESBL Screen for BD MAX^TM detected 22 (12.7%) ESBL-positive samples. No carbapenemase-producing isolates were detected. Two culture-positive samples remained negative with Check-Direct ESBL Screen for BD MAX^TM. Culture-negative but qPCR-positive discrepancy was observed in 12 samples (6.9%). Altogether, concordant results were obtained for 158 samples (91.3%; 9 positive and 149 negative).

Conclusion: Check-Direct ESBL Screen for BD MAX^TM is a fast screening method for ESBL carriage. However, several discrepant results were observed, which hinders interpretation. More clinical samples should be tested in combination with culture to evaluate the true benefits of this method.

Keywords: Antimicrobial resistance; Diagnostics; ESBL; Escherichia coli; Klebsiella pneumoniae; Whole-genome sequencing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Escherichia coli / genetics
Escherichia coli Infections*
Feces
Humans
Klebsiella pneumoniae* / genetics
beta-Lactamases / genetics

Substances

beta-Lactamases