Detection of antibiotic resistance genes from blood cultures: performance assessment and potential impact on antibiotic therapy management

Molecular assays may constitute a valid method for timely prediction of antimicrobial resistance and optimization of empirical antibiotic therapies. This study assessed ELITe MGB assays of blood cultures to detect the main carbapenemase and extended-spectrum beta-lactamase (ESBL) genes, Staphylococc...

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Bibliographic Details
Published in:The Journal of hospital infection 2019-08, Vol.102 (4), p.465-469
Main Authors: Bianco, G., Boattini, M., Iannaccone, M., Sidoti, F., Cavallo, R., Costa, C.
Format: Article
Language:English
Subjects:
Antimicrobial stewardship
Antimicrobial susceptibility
Blood culture
Molecular testing
Multi-drug resistance
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Summary:Molecular assays may constitute a valid method for timely prediction of antimicrobial resistance and optimization of empirical antibiotic therapies. This study assessed ELITe MGB assays of blood cultures to detect the main carbapenemase and extended-spectrum beta-lactamase (ESBL) genes, Staphylococcus aureus and mec genes in less than 3 h. Excellent agreement was found between the results of genotypic and conventional phenotypic approaches. Retrospective analysis of medical records revealed that approximately 50% of bloodstream infections caused by ESBL-producing Enterobacteriaceae, carbapenemase-producing Enterobacteriaceae or meticillin-resistant S. aureus were initially treated with inactive drugs. Overall, 36.3% of patients could have been treated with appropriate therapy at least 24 h earlier if molecular data had been used.
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2019.03.007