Cargando…

Directed carbapenemase testing is no longer just for Enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant P. aeruginosa

Molecular carbapenem-resistance testing, such as for the presence of carbapenemases genes, is commonly implemented for the detection of carbapenemase-producing Enterobacterales. Carbapenemase-producing P. aeruginosa is also associated with significant morbidity and mortality, although; prevalence ma...

Descripción completa

Detalles Bibliográficos
Autores principales: Gill, Christian M., Rajkotia, Poonam, Roberts, Amity L., Tenover, Fred C., Nicolau, David P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980414/
https://www.ncbi.nlm.nih.gov/pubmed/36786132
http://dx.doi.org/10.1080/22221751.2023.2179344
_version_ 1784899910957531136
author Gill, Christian M.
Rajkotia, Poonam
Roberts, Amity L.
Tenover, Fred C.
Nicolau, David P.
author_facet Gill, Christian M.
Rajkotia, Poonam
Roberts, Amity L.
Tenover, Fred C.
Nicolau, David P.
author_sort Gill, Christian M.
collection PubMed
description Molecular carbapenem-resistance testing, such as for the presence of carbapenemases genes, is commonly implemented for the detection of carbapenemase-producing Enterobacterales. Carbapenemase-producing P. aeruginosa is also associated with significant morbidity and mortality, although; prevalence may be underappreciated in the United States due to a lack of carbapenemase testing. The present study sought to compare hands-on time, cost and workflow implementation of carbapenemase gene testing in Enterobacterales and P. aeruginosa isolates versus sending out isolates to a public health laboratory (PHL) for testing to assess if in-house can provide actionable results. The time to carbapenemase gene results were compared. Differences in cost for infection prevention measures were extrapolated from the time of positive carbapenemase gene detection in-house versus PHL. The median time to perform carbapenemase gene testing was 7.5 min (range 5–14) versus 10 min (range 8–22) for preparation to send isolates to the PHL. In-house testing produced same day results compared with a median of 6 days (range 3–14) to receive results from PHL. Cost of in-house testing and send outs were similar ($46.92 versus $40.53, respectively). If contact precautions for patients are implemented until carbapenemase genes are ruled out, in-house testing can save an estimated $76,836.60 annually. Extension of in-house carbapenemase testing to include P. aeruginosa provides actionable results 3–14 days earlier than PHL Standard Pathway testing, facilitating guided therapeutic decisions and infection prevention measures. Supplemental phenotypic algorithms can be implemented to curb the cost of P. aeruginosa carbapenemases testing by identifying isolates most likely to harbour carbapenemases.
format Online
Article
Text
id pubmed-9980414
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Taylor & Francis
record_format MEDLINE/PubMed
spelling pubmed-99804142023-03-03 Directed carbapenemase testing is no longer just for Enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant P. aeruginosa Gill, Christian M. Rajkotia, Poonam Roberts, Amity L. Tenover, Fred C. Nicolau, David P. Emerg Microbes Infect Antimicrobial Agents Molecular carbapenem-resistance testing, such as for the presence of carbapenemases genes, is commonly implemented for the detection of carbapenemase-producing Enterobacterales. Carbapenemase-producing P. aeruginosa is also associated with significant morbidity and mortality, although; prevalence may be underappreciated in the United States due to a lack of carbapenemase testing. The present study sought to compare hands-on time, cost and workflow implementation of carbapenemase gene testing in Enterobacterales and P. aeruginosa isolates versus sending out isolates to a public health laboratory (PHL) for testing to assess if in-house can provide actionable results. The time to carbapenemase gene results were compared. Differences in cost for infection prevention measures were extrapolated from the time of positive carbapenemase gene detection in-house versus PHL. The median time to perform carbapenemase gene testing was 7.5 min (range 5–14) versus 10 min (range 8–22) for preparation to send isolates to the PHL. In-house testing produced same day results compared with a median of 6 days (range 3–14) to receive results from PHL. Cost of in-house testing and send outs were similar ($46.92 versus $40.53, respectively). If contact precautions for patients are implemented until carbapenemase genes are ruled out, in-house testing can save an estimated $76,836.60 annually. Extension of in-house carbapenemase testing to include P. aeruginosa provides actionable results 3–14 days earlier than PHL Standard Pathway testing, facilitating guided therapeutic decisions and infection prevention measures. Supplemental phenotypic algorithms can be implemented to curb the cost of P. aeruginosa carbapenemases testing by identifying isolates most likely to harbour carbapenemases. Taylor & Francis 2023-03-01 /pmc/articles/PMC9980414/ /pubmed/36786132 http://dx.doi.org/10.1080/22221751.2023.2179344 Text en © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group, on behalf of Shanghai Shangyixun Cultural Communication Co., Ltd https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Antimicrobial Agents
Gill, Christian M.
Rajkotia, Poonam
Roberts, Amity L.
Tenover, Fred C.
Nicolau, David P.
Directed carbapenemase testing is no longer just for Enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant P. aeruginosa
title Directed carbapenemase testing is no longer just for Enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant P. aeruginosa
title_full Directed carbapenemase testing is no longer just for Enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant P. aeruginosa
title_fullStr Directed carbapenemase testing is no longer just for Enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant P. aeruginosa
title_full_unstemmed Directed carbapenemase testing is no longer just for Enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant P. aeruginosa
title_short Directed carbapenemase testing is no longer just for Enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant P. aeruginosa
title_sort directed carbapenemase testing is no longer just for enterobacterales: cost, labor, and workflow assessment of expanding carbapenemase testing to carbapenem-resistant p. aeruginosa
topic Antimicrobial Agents
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980414/
https://www.ncbi.nlm.nih.gov/pubmed/36786132
http://dx.doi.org/10.1080/22221751.2023.2179344
work_keys_str_mv AT gillchristianm directedcarbapenemasetestingisnolongerjustforenterobacteralescostlaborandworkflowassessmentofexpandingcarbapenemasetestingtocarbapenemresistantpaeruginosa
AT rajkotiapoonam directedcarbapenemasetestingisnolongerjustforenterobacteralescostlaborandworkflowassessmentofexpandingcarbapenemasetestingtocarbapenemresistantpaeruginosa
AT robertsamityl directedcarbapenemasetestingisnolongerjustforenterobacteralescostlaborandworkflowassessmentofexpandingcarbapenemasetestingtocarbapenemresistantpaeruginosa
AT tenoverfredc directedcarbapenemasetestingisnolongerjustforenterobacteralescostlaborandworkflowassessmentofexpandingcarbapenemasetestingtocarbapenemresistantpaeruginosa
AT nicolaudavidp directedcarbapenemasetestingisnolongerjustforenterobacteralescostlaborandworkflowassessmentofexpandingcarbapenemasetestingtocarbapenemresistantpaeruginosa