De Muynck Emilie, Vandendriessche Stien, Messiaen Anne-Sophie, Decommer Kristen, Huis In 't Veld Diana, De Waele Jan J, Boelens Jerina
Department of Medical Microbiology, Ghent University Hospital, Ghent, Belgium.
Department of Internal Medicine and Infectious Diseases, Ghent University Hospital, Ghent, Belgium.
Eur J Clin Microbiol Infect Dis. 2025 Mar;44(3):729-732. doi: 10.1007/s10096-024-05007-2. Epub 2024 Dec 19.
Rapid antimicrobial susceptibility testing of positive blood cultures can enhance antimicrobial stewardship and patient outcomes. We present a case where OXA-48-producing Klebsiella pneumoniae with low-level carbapenem resistance was suspected 6 h after blood-culture positivity, based on ASTar system (Q-Linea, Sweden) results. OXA-48 carbapenemase presence was confirmed by the OXA-48 K-SeT lateral flow assay (Coris, Belgium) on a short-term subculture. This led to timely therapeutic adjustments. Following this case, we validated the OXA-48 K-SeT and Xpert Carba-R assay (Cepheid, USA) on short-term incubated (6 h) subcultures of positive blood cultures, demonstrating that OXA-48 K-SeT and Xpert Carba-R respectively accurately identified OXA-48 and various (OXA-48, VIM, NDM, KPC, IMP) carbapenemase-producing Enterobacterales (CPE) types. Both assays prove valuable for rapid CPE detection in clinical settings.
对阳性血培养物进行快速抗菌药物敏感性测试可加强抗菌药物管理并改善患者预后。我们报告了这样一个病例：基于ASTar系统（瑞典Q-Linea公司）的结果，在血培养阳性6小时后怀疑有产OXA-48的肺炎克雷伯菌，其对碳青霉烯类药物呈低水平耐药。通过在短期传代培养物上进行OXA-48 K-SeT侧向流动分析法（比利时Coris公司）确认了OXA-48碳青霉烯酶的存在。这使得能够及时调整治疗方案。在此病例之后，我们在阳性血培养物的短期培养（6小时）传代培养物上验证了OXA-48 K-SeT和Xpert Carba-R检测法（美国赛沛公司），证明OXA-48 K-SeT和Xpert Carba-R分别准确鉴定出了OXA-48以及各种（OXA-48、VIM、NDM、KPC、IMP）产碳青霉烯酶肠杆菌科细菌（CPE）类型。这两种检测法在临床环境中对快速检测CPE均具有重要价值。
