Rapid detection of antibiotic-resistant organism carriage for infection prevention.

Rapid detection of multidrug-resistant organism (MDRO) carriers could help reduce MDRO infections by allowing for faster institution of prevention measures. However, improving the turnaround time (TAT) of a test requires attention to more than the analytic TAT, and will only occur if postanalytic processes (test reporting and care interventions) are also rapid and efficient. Obstacles to rapid MDRO test development include complex evolving resistance mechanisms, performance directly on mixed samples (eg, nares, stool), and adaptation of new methods for routine clinical diagnostic use. Existing data to support the clinical utility of rapid detection (vs standard culture methods) are scant. For these reasons, rapid detection of MDRO carriers remains a work in progress. Future efforts should be on developing rapid tests to detect multidrug-resistant gram-negative rods, particularly those harboring β-lactamases, and on performing clinical trials to determine how best to incorporate rapid detection of MDRO carriage into healthcare-associated infection prevention efforts.