Session Type: ePosters
Session Title: ePosters
Authors(s): V. Enne (1), A. Aydin (1), R. Baldan (2, 3), D. Owen (1), H. Richardson (2), F. Ricciardi (1), C. Russell (2), B. Nomamiukor-Ikeji (1), A.M. Swart (2), J. High (2), A. Colles (2), J. Barber (1), V. Gant (4), D. Livermore (2), J. O'grady (2, 5)
Authors Affiliations(s): (1) UCL, United Kingdom, (2) University of East Anglia, United Kingdom, (3) King's College, United Kingdom, (4) UCLH, United Kingdom, (5) Quadram Institute, United Kingdom
Third Party Affiliation: INHALE WP1 Study Group
Background:
Microbiological culture and susceptibility testing takes c. 48h and, for respiratory samples, has poor pathogen recovery. PCR-based rapid diagnostics offer a potential alternative. Here, we evaluate the performance of the Biofire FilmArray and Curetis Unyvero Pneumonia panel systems for identification of antimicrobial resistance determinants in respiratory secretions from ICU HAP/VAP patients, performed as part of the INHALE Study performance evaluation of these systems.
Methods:We collected 620 lower respiratory tract samples from patients with suspected or confirmed HAP/VAP at 15 critical care units. Antimicrobial resistance gene detection by the Unyvero and FilmArray pneumonia panels was compared with routine culture results, supplemented by further comprehensive culture of selected samples and investigation of resistance genes by Checkpoints microarray (beta-lactamases) and PCR (mecA/C).
Results:Unyvero found 6 acquired carbapenemase genes (2 blaNDM, 1 blaKPC and 3 blaVIM) in addition to 5 A. baumannii blaOXA-23 genes, whereas FilmArray found 3 acquired carbapenemases (1 each of blaKPC, blaIMP and blaVIM; it doesn't seek the genes encoding Acinetobacter OXA enzymes). Only two of these detections, one blaKPC and one blaVIM overlapped between the two tests. blaCTX-M was found by Unyvero in 14 specimens and by FilmArray in 32. mecA/C was found in the presence of S. aureus by Unyvero in 25 specimens and by FilmArray in 32, with 18 of these in common between the two tests. In respect of carbapenemase genes, detections of blaKPC (n=1) and blaOXA-23 (n= 5, Unyvero only) were in complete agreement with culture. FilmArray missed 1/2 cases where blaVIM was detected in a cultivated isolated, and Unyvero missed 3/15 cases blaCTX-M was present and 1/14 cases of MRSA. Unyvero detected one blaVIM and two blaNDM genes that could not be confirmed in cultivated isolates, FilmArray detected one blaIMP that was not confirmed.
Conclusions:Results between PCR tests and routine microbiology were discrepant, often because routine microbiology failed to isolate and/or report the relevant host organism. Further independent culture-based investigation confirmed that PCR detected several high-consequence antibiotic resistance genes that had been missed by culture. Direct-from-sample detection of antimicrobial resistance genes offers potential for optimised patient treatment and rapid identification of high consequence determinants.
Keyword(s): PCR diagnostics, hospital-acquired pneumonia, beta-lactamaseCOI Fees: Yes
Session Type: ePosters
Session Title: ePosters
Authors(s): V. Enne (1), A. Aydin (1), R. Baldan (2, 3), D. Owen (1), H. Richardson (2), F. Ricciardi (1), C. Russell (2), B. Nomamiukor-Ikeji (1), A.M. Swart (2), J. High (2), A. Colles (2), J. Barber (1), V. Gant (4), D. Livermore (2), J. O'grady (2, 5)
Authors Affiliations(s): (1) UCL, United Kingdom, (2) University of East Anglia, United Kingdom, (3) King's College, United Kingdom, (4) UCLH, United Kingdom, (5) Quadram Institute, United Kingdom
Third Party Affiliation: INHALE WP1 Study Group
Background:
Microbiological culture and susceptibility testing takes c. 48h and, for respiratory samples, has poor pathogen recovery. PCR-based rapid diagnostics offer a potential alternative. Here, we evaluate the performance of the Biofire FilmArray and Curetis Unyvero Pneumonia panel systems for identification of antimicrobial resistance determinants in respiratory secretions from ICU HAP/VAP patients, performed as part of the INHALE Study performance evaluation of these systems.
Methods:We collected 620 lower respiratory tract samples from patients with suspected or confirmed HAP/VAP at 15 critical care units. Antimicrobial resistance gene detection by the Unyvero and FilmArray pneumonia panels was compared with routine culture results, supplemented by further comprehensive culture of selected samples and investigation of resistance genes by Checkpoints microarray (beta-lactamases) and PCR (mecA/C).
Results:Unyvero found 6 acquired carbapenemase genes (2 blaNDM, 1 blaKPC and 3 blaVIM) in addition to 5 A. baumannii blaOXA-23 genes, whereas FilmArray found 3 acquired carbapenemases (1 each of blaKPC, blaIMP and blaVIM; it doesn't seek the genes encoding Acinetobacter OXA enzymes). Only two of these detections, one blaKPC and one blaVIM overlapped between the two tests. blaCTX-M was found by Unyvero in 14 specimens and by FilmArray in 32. mecA/C was found in the presence of S. aureus by Unyvero in 25 specimens and by FilmArray in 32, with 18 of these in common between the two tests. In respect of carbapenemase genes, detections of blaKPC (n=1) and blaOXA-23 (n= 5, Unyvero only) were in complete agreement with culture. FilmArray missed 1/2 cases where blaVIM was detected in a cultivated isolated, and Unyvero missed 3/15 cases blaCTX-M was present and 1/14 cases of MRSA. Unyvero detected one blaVIM and two blaNDM genes that could not be confirmed in cultivated isolates, FilmArray detected one blaIMP that was not confirmed.
Conclusions:Results between PCR tests and routine microbiology were discrepant, often because routine microbiology failed to isolate and/or report the relevant host organism. Further independent culture-based investigation confirmed that PCR detected several high-consequence antibiotic resistance genes that had been missed by culture. Direct-from-sample detection of antimicrobial resistance genes offers potential for optimised patient treatment and rapid identification of high consequence determinants.
Keyword(s): PCR diagnostics, hospital-acquired pneumonia, beta-lactamaseCOI Fees: Yes
UCL, London
Session Type: ePosters
Session Title: ePosters
Authors(s): V. Enne (1), A. Aydin (1), R. Baldan (2, 3), D. Owen (1), H. Richardson (2), F. Ricciardi (1), C. Russell (2), B. Nomamiukor-Ikeji (1), A.M. Swart (2), J. High (2), A. Colles (2), J. Barber (1), V. Gant (4), D. Livermore (2), J. O'grady (2, 5)
Authors Affiliations(s): (1) UCL, United Kingdom, (2) University of East Anglia, United Kingdom, (3) King's College, United Kingdom, (4) UCLH, United Kingdom, (5) Quadram Institute, United Kingdom
Third Party Affiliation: INHALE WP1 Study Group
Background:
Microbiological culture and susceptibility testing takes c. 48h and, for respiratory samples, has poor pathogen recovery. PCR-based rapid diagnostics offer a potential alternative. Here, we evaluate the performance of the Biofire FilmArray and Curetis Unyvero Pneumonia panel systems for identification of antimicrobial resistance determinants in respiratory secretions from ICU HAP/VAP patients, performed as part of the INHALE Study performance evaluation of these systems.
Methods:We collected 620 lower respiratory tract samples from patients with suspected or confirmed HAP/VAP at 15 critical care units. Antimicrobial resistance gene detection by the Unyvero and FilmArray pneumonia panels was compared with routine culture results, supplemented by further comprehensive culture of selected samples and investigation of resistance genes by Checkpoints microarray (beta-lactamases) and PCR (mecA/C).
Results:Unyvero found 6 acquired carbapenemase genes (2 blaNDM, 1 blaKPC and 3 blaVIM) in addition to 5 A. baumannii blaOXA-23 genes, whereas FilmArray found 3 acquired carbapenemases (1 each of blaKPC, blaIMP and blaVIM; it doesn't seek the genes encoding Acinetobacter OXA enzymes). Only two of these detections, one blaKPC and one blaVIM overlapped between the two tests. blaCTX-M was found by Unyvero in 14 specimens and by FilmArray in 32. mecA/C was found in the presence of S. aureus by Unyvero in 25 specimens and by FilmArray in 32, with 18 of these in common between the two tests. In respect of carbapenemase genes, detections of blaKPC (n=1) and blaOXA-23 (n= 5, Unyvero only) were in complete agreement with culture. FilmArray missed 1/2 cases where blaVIM was detected in a cultivated isolated, and Unyvero missed 3/15 cases blaCTX-M was present and 1/14 cases of MRSA. Unyvero detected one blaVIM and two blaNDM genes that could not be confirmed in cultivated isolates, FilmArray detected one blaIMP that was not confirmed.
Conclusions:Results between PCR tests and routine microbiology were discrepant, often because routine microbiology failed to isolate and/or report the relevant host organism. Further independent culture-based investigation confirmed that PCR detected several high-consequence antibiotic resistance genes that had been missed by culture. Direct-from-sample detection of antimicrobial resistance genes offers potential for optimised patient treatment and rapid identification of high consequence determinants.
Keyword(s): PCR diagnostics, hospital-acquired pneumonia, beta-lactamaseCOI Fees: Yes
Session Type: ePosters
Session Title: ePosters
Authors(s): V. Enne (1), A. Aydin (1), R. Baldan (2, 3), D. Owen (1), H. Richardson (2), F. Ricciardi (1), C. Russell (2), B. Nomamiukor-Ikeji (1), A.M. Swart (2), J. High (2), A. Colles (2), J. Barber (1), V. Gant (4), D. Livermore (2), J. O'grady (2, 5)
Authors Affiliations(s): (1) UCL, United Kingdom, (2) University of East Anglia, United Kingdom, (3) King's College, United Kingdom, (4) UCLH, United Kingdom, (5) Quadram Institute, United Kingdom
Third Party Affiliation: INHALE WP1 Study Group
Background:
Microbiological culture and susceptibility testing takes c. 48h and, for respiratory samples, has poor pathogen recovery. PCR-based rapid diagnostics offer a potential alternative. Here, we evaluate the performance of the Biofire FilmArray and Curetis Unyvero Pneumonia panel systems for identification of antimicrobial resistance determinants in respiratory secretions from ICU HAP/VAP patients, performed as part of the INHALE Study performance evaluation of these systems.
Methods:We collected 620 lower respiratory tract samples from patients with suspected or confirmed HAP/VAP at 15 critical care units. Antimicrobial resistance gene detection by the Unyvero and FilmArray pneumonia panels was compared with routine culture results, supplemented by further comprehensive culture of selected samples and investigation of resistance genes by Checkpoints microarray (beta-lactamases) and PCR (mecA/C).
Results:Unyvero found 6 acquired carbapenemase genes (2 blaNDM, 1 blaKPC and 3 blaVIM) in addition to 5 A. baumannii blaOXA-23 genes, whereas FilmArray found 3 acquired carbapenemases (1 each of blaKPC, blaIMP and blaVIM; it doesn't seek the genes encoding Acinetobacter OXA enzymes). Only two of these detections, one blaKPC and one blaVIM overlapped between the two tests. blaCTX-M was found by Unyvero in 14 specimens and by FilmArray in 32. mecA/C was found in the presence of S. aureus by Unyvero in 25 specimens and by FilmArray in 32, with 18 of these in common between the two tests. In respect of carbapenemase genes, detections of blaKPC (n=1) and blaOXA-23 (n= 5, Unyvero only) were in complete agreement with culture. FilmArray missed 1/2 cases where blaVIM was detected in a cultivated isolated, and Unyvero missed 3/15 cases blaCTX-M was present and 1/14 cases of MRSA. Unyvero detected one blaVIM and two blaNDM genes that could not be confirmed in cultivated isolates, FilmArray detected one blaIMP that was not confirmed.
Conclusions:Results between PCR tests and routine microbiology were discrepant, often because routine microbiology failed to isolate and/or report the relevant host organism. Further independent culture-based investigation confirmed that PCR detected several high-consequence antibiotic resistance genes that had been missed by culture. Direct-from-sample detection of antimicrobial resistance genes offers potential for optimised patient treatment and rapid identification of high consequence determinants.
Keyword(s): PCR diagnostics, hospital-acquired pneumonia, beta-lactamaseCOI Fees: Yes