Prevalence of carbapenem resistance and carbapenemase production among Enterobacteriaceae isolated from urine in the UK: results of the UK infection-Carbapenem Resistance Evaluation Surveillance Trial (iCREST-UK)

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Prevalence of carbapenem resistance and carbapenemase production among Enterobacteriaceae isolated from urine in the UK : results of the UK infection-Carbapenem Resistance Evaluation Surveillance Trial (iCREST-UK). / Woodford, Neil; Xu-McCrae, Li; Mushtaq, Shazad; Wu, Houdini Ho Tin; Ellington, Matthew J; Lancaster, Owen; Davies, Frances; Donaldson, Hugo; Rao, G Gopal; Verma, Anita; Wareham, David W; Ciesielczuk, Holly; Stone, Gregory G; Irani, Paurus M; Bracher, Simon; Hawkey, Peter M.

In: Journal of Antimicrobial Chemotherapy, 15.12.2017.

Research output: Contribution to journalArticlepeer-review

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APA

Woodford, N., Xu-McCrae, L., Mushtaq, S., Wu, H. H. T., Ellington, M. J., Lancaster, O., Davies, F., Donaldson, H., Rao, G. G., Verma, A., Wareham, D. W., Ciesielczuk, H., Stone, G. G., Irani, P. M., Bracher, S., & Hawkey, P. M. (2017). Prevalence of carbapenem resistance and carbapenemase production among Enterobacteriaceae isolated from urine in the UK: results of the UK infection-Carbapenem Resistance Evaluation Surveillance Trial (iCREST-UK). Journal of Antimicrobial Chemotherapy. https://doi.org/10.1093/jac/dkx471

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Author

Woodford, Neil ; Xu-McCrae, Li ; Mushtaq, Shazad ; Wu, Houdini Ho Tin ; Ellington, Matthew J ; Lancaster, Owen ; Davies, Frances ; Donaldson, Hugo ; Rao, G Gopal ; Verma, Anita ; Wareham, David W ; Ciesielczuk, Holly ; Stone, Gregory G ; Irani, Paurus M ; Bracher, Simon ; Hawkey, Peter M. / Prevalence of carbapenem resistance and carbapenemase production among Enterobacteriaceae isolated from urine in the UK : results of the UK infection-Carbapenem Resistance Evaluation Surveillance Trial (iCREST-UK). In: Journal of Antimicrobial Chemotherapy. 2017.

Bibtex

@article{38194886f20c495686e09f809f253e5d,
title = "Prevalence of carbapenem resistance and carbapenemase production among Enterobacteriaceae isolated from urine in the UK: results of the UK infection-Carbapenem Resistance Evaluation Surveillance Trial (iCREST-UK)",
abstract = "Objectives: Although carbapenem susceptibility testing has been recommended for all Enterobacteriaceae from clinical specimens, for practical reasons a carbapenem is not included in many primary antibiotic panels for urine specimens. The 'iCREST' study sought carbapenemase-producing Enterobacteriaceae (CPE) in routine urine specimens yielding Gram-negative growth in five diagnostic laboratories in the UK. We sought also to compare locally and centrally determined MICs of meropenem and ceftazidime/avibactam.Methods: Positive growth from up to 2000 urine specimens per laboratory was plated onto chromID{\textregistered} CARBA SMART agar. Suspected CPE colonies were tested locally by Etest for susceptibility to meropenem and ceftazidime/avibactam, and referred to central laboratories for PCR confirmation of CPE status and microbroth MIC determination.Results: Twenty-two suspected CPE were identified from 7504 urine specimens. Ten were confirmed by PCR to have NDM (5), IMP (2), KPC (2) or OXA-48-like (1) carbapenemases. Locally determined ceftazidime/avibactam MICs showed complete categorical agreement with those determined centrally by microbroth methodology. The seven ceftazidime/avibactam-resistant isolates (MICs ≥256 mg/L) had NDM or IMP metallo-carbapenemases.Conclusions: The frequency of confirmed CPE among Gram-negative urinary isolates was low, at 0.13% (10/7504), but CPE were found in urines at all five participating sites and the diversity of carbapenemase genes detected reflected the complex epidemiology of CPE in the UK. These data can inform local policies about the cost-effectiveness and clinical value of testing Gram-negative bacteria from urine specimens routinely against a carbapenem as part of patient management and/or infection prevention and control strategies.",
keywords = " antibiotics, Polymerase Chain Reaction, carbapenem",
author = "Neil Woodford and Li Xu-McCrae and Shazad Mushtaq and Wu, {Houdini Ho Tin} and Ellington, {Matthew J} and Owen Lancaster and Frances Davies and Hugo Donaldson and Rao, {G Gopal} and Anita Verma and Wareham, {David W} and Holly Ciesielczuk and Stone, {Gregory G} and Irani, {Paurus M} and Simon Bracher and Hawkey, {Peter M}",
year = "2017",
month = dec,
day = "15",
doi = "10.1093/jac/dkx471",
language = "English",
journal = "Journal of Antimicrobial Chemotherapy",
issn = "0305-7453",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - Prevalence of carbapenem resistance and carbapenemase production among Enterobacteriaceae isolated from urine in the UK

T2 - results of the UK infection-Carbapenem Resistance Evaluation Surveillance Trial (iCREST-UK)

AU - Woodford, Neil

AU - Xu-McCrae, Li

AU - Mushtaq, Shazad

AU - Wu, Houdini Ho Tin

AU - Ellington, Matthew J

AU - Lancaster, Owen

AU - Davies, Frances

AU - Donaldson, Hugo

AU - Rao, G Gopal

AU - Verma, Anita

AU - Wareham, David W

AU - Ciesielczuk, Holly

AU - Stone, Gregory G

AU - Irani, Paurus M

AU - Bracher, Simon

AU - Hawkey, Peter M

PY - 2017/12/15

Y1 - 2017/12/15

N2 - Objectives: Although carbapenem susceptibility testing has been recommended for all Enterobacteriaceae from clinical specimens, for practical reasons a carbapenem is not included in many primary antibiotic panels for urine specimens. The 'iCREST' study sought carbapenemase-producing Enterobacteriaceae (CPE) in routine urine specimens yielding Gram-negative growth in five diagnostic laboratories in the UK. We sought also to compare locally and centrally determined MICs of meropenem and ceftazidime/avibactam.Methods: Positive growth from up to 2000 urine specimens per laboratory was plated onto chromID® CARBA SMART agar. Suspected CPE colonies were tested locally by Etest for susceptibility to meropenem and ceftazidime/avibactam, and referred to central laboratories for PCR confirmation of CPE status and microbroth MIC determination.Results: Twenty-two suspected CPE were identified from 7504 urine specimens. Ten were confirmed by PCR to have NDM (5), IMP (2), KPC (2) or OXA-48-like (1) carbapenemases. Locally determined ceftazidime/avibactam MICs showed complete categorical agreement with those determined centrally by microbroth methodology. The seven ceftazidime/avibactam-resistant isolates (MICs ≥256 mg/L) had NDM or IMP metallo-carbapenemases.Conclusions: The frequency of confirmed CPE among Gram-negative urinary isolates was low, at 0.13% (10/7504), but CPE were found in urines at all five participating sites and the diversity of carbapenemase genes detected reflected the complex epidemiology of CPE in the UK. These data can inform local policies about the cost-effectiveness and clinical value of testing Gram-negative bacteria from urine specimens routinely against a carbapenem as part of patient management and/or infection prevention and control strategies.

AB - Objectives: Although carbapenem susceptibility testing has been recommended for all Enterobacteriaceae from clinical specimens, for practical reasons a carbapenem is not included in many primary antibiotic panels for urine specimens. The 'iCREST' study sought carbapenemase-producing Enterobacteriaceae (CPE) in routine urine specimens yielding Gram-negative growth in five diagnostic laboratories in the UK. We sought also to compare locally and centrally determined MICs of meropenem and ceftazidime/avibactam.Methods: Positive growth from up to 2000 urine specimens per laboratory was plated onto chromID® CARBA SMART agar. Suspected CPE colonies were tested locally by Etest for susceptibility to meropenem and ceftazidime/avibactam, and referred to central laboratories for PCR confirmation of CPE status and microbroth MIC determination.Results: Twenty-two suspected CPE were identified from 7504 urine specimens. Ten were confirmed by PCR to have NDM (5), IMP (2), KPC (2) or OXA-48-like (1) carbapenemases. Locally determined ceftazidime/avibactam MICs showed complete categorical agreement with those determined centrally by microbroth methodology. The seven ceftazidime/avibactam-resistant isolates (MICs ≥256 mg/L) had NDM or IMP metallo-carbapenemases.Conclusions: The frequency of confirmed CPE among Gram-negative urinary isolates was low, at 0.13% (10/7504), but CPE were found in urines at all five participating sites and the diversity of carbapenemase genes detected reflected the complex epidemiology of CPE in the UK. These data can inform local policies about the cost-effectiveness and clinical value of testing Gram-negative bacteria from urine specimens routinely against a carbapenem as part of patient management and/or infection prevention and control strategies.

KW - antibiotics

KW - Polymerase Chain Reaction

KW - carbapenem

U2 - 10.1093/jac/dkx471

DO - 10.1093/jac/dkx471

M3 - Article

C2 - 29253163

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

ER -