Value of integron detection for predicting antibiotic resistance in patients with Gram-negative septicaemia

Abstract Multidrug-resistant Enterobacteriaceae are a major public health threat and complicate the choice of drugs for empirical antibiotic therapy, especially in sepsis patients who require rapid, appropriate treatment. The objective of this study was to examine the value of integrons as a global...

Full description

Saved in:
Bibliographic Details
Published in:International journal of antimicrobial agents 2014-10, Vol.44 (4), p.351-353
Main Authors: Barraud, Olivier, François, Bruno, Chainier, Delphine, Vignaud, Julie, Ploy, Marie-Cécile
Format: Article
Language:English
Subjects:
Antibiotic resistance
Blood - microbiology
Blood culture
Drug Resistance, Bacterial
Enterobacteriaceae
Enterobacteriaceae - genetics
Enterobacteriaceae - isolation & purification
Enterobacteriaceae Infections - microbiology
Genetic marker
Genotyping Techniques - methods
Humans
Infectious Disease
Integron
Integrons
Microbial Sensitivity Tests - methods
Predictive Value of Tests
Real-Time Polymerase Chain Reaction - methods
Sepsis - microbiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Multidrug-resistant Enterobacteriaceae are a major public health threat and complicate the choice of drugs for empirical antibiotic therapy, especially in sepsis patients who require rapid, appropriate treatment. The objective of this study was to examine the value of integrons as a global predictive marker of acquired antibiotic resistance in septicaemia-causing Enterobacteriaceae by direct detection in positive blood cultures. The integron genetic marker can be detected in a single test, whereas multiple PCRs are needed to detect the hundreds of known antibiotic resistance genes. A total of 166 positive blood cultures were included in the study, and integrons were detected with a quantitative PCR method both in positive blood cultures and isolated Enterobacteriaceae. The results of integron detection directly on positive blood cultures were consistent in 98.8% of cases with integron detection in isolated Enterobacteriaceae. Negative predictive values (NPVs) were >90% for resistance to third-generation cephalosporins, aminoglycosides, ciprofloxacin and trimethoprim/sulfamethoxazole. In the current context of antibiotic stewardship, these good NPVs indicate that this method might be useful for preserving broad-spectrum antibiotics. The results of this proof-of-concept study must be confirmed in order to demonstrate the clinical relevance of integron detection, not only in positive blood cultures but also, to gain time, in raw biological samples.
ISSN:0924-8579
1872-7913
DOI:10.1016/j.ijantimicag.2014.06.008