Maugeri Gaetano, Calvo Maddalena, Scalia Guido, Stefani Stefania
Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, 95123 Catania, Italy.
U.O.C. Laboratory Analysis Unit, A.O.U. "Policlinico-San Marco", 95123 Catania, Italy.
Diagnostics (Basel). 2025 Aug 22;15(17):2128. doi: 10.3390/diagnostics15172128.
. Multi-drug-resistant (MDR) microorganisms pose a significant challenge in healthcare settings, particularly with beta-lactam-resistant Gram-negative bacteria and glycopeptide-resistant enterococci. Culture represents the most reliable technique in determining their presence within surveillance swabs. However, it requires a long time-to-result (TTR) and shows low sensitivity. Molecular techniques integrate diagnostic procedures, allowing TTR reduction and precise identification of genes. . During our usual surveillance campaign, we had the opportunity to evaluate the Allplex Entero-DR assay (Seegene Inc., Seoul, Republic of Korea) and the Entero-DR Plus assay (Arrow Diagnostics srl, Genova, Italy) molecular kits for the detection of extended-β-lactamases (ESBL), carbapenem- and vancomycin-resistant genes, as well as spp. and spp. identification directly from rectal swabs. A comparison between these tests and the culture-based routine completed the study. . The analysis included 300 rectal swabs from the University Hospital Policlinico (Catania, Italy). One hundred and eighty-eight samples (62.6%) resulted as positive for at least one Allplex™ target, reaching optimal sensitivity and negative predictive value (100%). Our results underlined the ubiquitous CTX-M and genes presence and demonstrated the diffusion of double-carbapenemases genes and metallo-β-lactamases-producing strains. In our epidemiological setting, few data were collected about carbapenem-resistant and spp., which require further evaluations on simultaneous respiratory colonization and higher sample numbers. . Our analysis highlighted the importance of combining conventional and advanced diagnostic methods in investigating MDR pathogens. The right approach should be based on the prevalence and variability of resistance mechanisms within a specific epidemiological area. Remarkably, molecular screenings may exclude negative samples within high-risk areas due to a significant negative predictive value.
多重耐药（MDR）微生物在医疗环境中构成了重大挑战，尤其是对β-内酰胺耐药的革兰氏阴性菌和糖肽耐药肠球菌。培养是确定监测拭子中是否存在这些微生物的最可靠技术。然而，其结果回报时间（TTR）长且灵敏度低。分子技术整合了诊断程序，可缩短结果回报时间并精确鉴定基因。在我们常规的监测活动中，我们有机会评估Allplex Entero-DR检测试剂盒（韩国首尔Seegene公司）和Entero-DR Plus检测试剂盒（意大利热那亚Arrow Diagnostics srl公司），用于直接从直肠拭子中检测超广谱β-内酰胺酶（ESBL）、碳青霉烯和万古霉素耐药基因，以及鉴定某些菌种。将这些检测与基于培养的常规方法进行比较以完成本研究。该分析纳入了来自意大利卡塔尼亚大学综合医院的300份直肠拭子。188份样本（62.6%）至少对一种Allplex™靶点呈阳性，达到了最佳灵敏度和阴性预测值（100%）。我们的结果强调了CTX-M和某些基因普遍存在，并证明了双碳青霉烯酶基因和产金属β-内酰胺酶菌株的传播。在我们的流行病学环境中，关于耐碳青霉烯的某些菌种的数据收集较少，这需要对同时发生的呼吸道定植情况进行进一步评估，并增加样本量。我们的分析强调了在调查MDR病原体时结合传统和先进诊断方法的重要性。正确的方法应基于特定流行病学区域内耐药机制的流行情况和变异性。值得注意的是，由于显著的阴性预测值，分子筛查可能会排除高风险区域内的阴性样本。
