The diagnostic accuracy of the GeneXpert ESBL- ampC prototype assay for rapid PCR-based detection of extended-spectrum beta-lactamase genes directly from urine.
Sofie C M TopsClaire E P SchapendonkJordy P M CoolenFred C TenoverIsabella A TicklerWillem J G MelchersHeiman F L WertheimPublished in: Microbiology spectrum (2023)
Early identification of complicated urinary tract infections caused by ESBL-producing Enterobacterales has the potential to limit the use of carbapenems to those patients without alternative antibiotic options and avoid the empirical use of carbapenems in patients without ESBL-producing bacteria. The purpose for such a test will differ by setting and ESBL prevalence rates. Countries with low ESBL rates and cephalosporins as empiric treatment (e.g., The Netherlands) will need a rule-in test to decide to use carbapenems, while countries with high ESBL rates and empiric carbapenem treatment will need a rule-out test for ESBLs to de-escalate therapy early. Anyway, such as a test would-at least theoretically-improve patient care and reduce selective pressure for the emergence of carbapenem resistance.
Keyphrases
- klebsiella pneumoniae
- escherichia coli
- end stage renal disease
- urinary tract infection
- chronic kidney disease
- multidrug resistant
- ejection fraction
- newly diagnosed
- peritoneal dialysis
- gram negative
- risk factors
- acinetobacter baumannii
- high throughput
- stem cells
- gene expression
- climate change
- label free
- replacement therapy
- bioinformatics analysis
- real time pcr