Detection of Colonization by carbapenem resistant organisms (CRO) by real time PCR (qPCR) from rectal swabs in a large population of patients with chronic renal disease

• Published in: The Journal of hospital infection 2017
• Main Authors: Rezende, T.F.T, Doi, A.M, Quiles, MG s, Pignatari, A.C.C, Manfrendi, S, Grothe, C, Taminato, M, Barbosa, D.A
• Format: Article
• Language: English
• Subjects: Infectious Disease
• ISSN: 0195-6701
• DOI: 10.1016/j.jhin.2017.03.021

Abstract Background Carbapenem-Resistant Organism (CRO) colonization is a serious problem that increases the risk of infection and contributes to dissemination of antimicrobial resistance in health care associated environments. The risks of acquisition and dissemination of CRO are high in chronic renal failure patients and the surveillance culture is recommended as a component of infection control programmes. The aim of this study was to assess colonization by CRO, comparing phenotypic and molecular-based methods of diagnostics, in rectal swabs in a large population of chronic renal failure patients. Methods A total of 1092 rectal swabs (ESwabTM) were collected at two different times from 546 chronic kidney disease (CKD) patients from a specialized tertiary care University Center. They were divided into three groups: conservative treatment (129), dialysis (217) and transplanted patients (200). A chromogenic (CHROmagar) KPC agar and the multiplex qPCR targeting carbapenemase-encoding genes were tested as phenotypic and molecular screening for carbapenemase production. MALDI-TOF and conventional PCR were also performed to the isolates grown on CHROmagar. Results Among the 1,092 samples, 150 (13.7%) were found as KPC producers according to CHROmagar. Only 26 (2.4%) were confirmed as KPC by conventional PCR. According to qPCR direct from swab, 31 (2.8%) were positive for KPC, 39 (3,6%) for GES and 3 (0,3%) for SPM with a 0,256 Kappa index. Conclusions The qPCR technique provides faster results when compared to culture method and enables rapid implementation of control measures and interventions to reduce the spread of CRO in health care settings, especially among CKD patients.