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Evaluation of Xpert Carba-R Assay v.2 to Detect Carbapenemase Genes in Two Hospitals in Korea

DC FieldValueLanguage
dc.contributor.author최준용-
dc.contributor.author용동은-
dc.date.accessioned2020-09-28T11:29:59Z-
dc.date.available2020-09-28T11:29:59Z-
dc.date.issued2020-05-
dc.identifier.issn2234-3806-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/179208-
dc.description.abstractBackground: As the spread of carbapenemase-producing Enterobacteriaceae poses a critical threat to public health, rapid detection of carbapenemase genes is urgently required for prompt initiation of appropriate antimicrobial therapy and infection control. We evaluated the performance of Xpert Carba-R v.2 (Cepheid, USA) compared with that of culture-based conventional PCR. Methods: Using the results of 5,479 consecutive clinical rectal swabs, discrepant analysis (enriched culture followed by PCR) was performed for all discordant samples (N=100), which were Carba-R v.2-positive and culture-negative. Results: Among the samples, 206 carbapenemase genes (3.6%) were detected by Carba-R v.2. The sensitivity and specificity were 95.0% and 98.1%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 49.0% and 99.9%, respectively. Following discrepant analysis, the PPV increased to 73.5% and the low PPV (8.1%) of the 86 non-KPC improved to 48.8%. Among the 105 discrepancies, NDM was the most frequently observed (N=56), followed by KPC (N=26), VIM (N=10), IMP (N=8), OXA-48 (N=5). The threshold cycle values between discordant vs. concordant and resolved groups were significantly different (P<0.001). Conclusions: Carba-R v.2 is a rapid and sensitive method for detecting carbapenemase-encoding genes compared with culture-based conventional PCR. Most of our discrepant results were non-KPC genes. Thus, the clinical significance of the non-KPC positive cases detected by Carba-R v.2 should be investigated. This assay would be useful for deciding whether to isolate pre-exposed patients in hospital settings, based on the high specificity and NPV.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherKorean Society for Laboratory Medicine-
dc.relation.isPartOfANNALS OF LABORATORY MEDICINE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleEvaluation of Xpert Carba-R Assay v.2 to Detect Carbapenemase Genes in Two Hospitals in Korea-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorJung Hyun Byun-
dc.contributor.googleauthorYoung Ah Kim-
dc.contributor.googleauthorMilee Kim-
dc.contributor.googleauthorBomi Kim-
dc.contributor.googleauthorJun Yong Choi-
dc.contributor.googleauthorYoon Soo Park-
dc.contributor.googleauthorDongeun Yong-
dc.identifier.doi10.3343/alm.2020.40.3.209-
dc.contributor.localIdA04191-
dc.contributor.localIdA02423-
dc.contributor.localIdA02423-
dc.relation.journalcodeJ00164-
dc.identifier.eissn2234-3814-
dc.identifier.pmid31858760-
dc.subject.keywordCarbapenemase-producing Enterobacteriaceae-
dc.subject.keywordInfection control-
dc.subject.keywordKPC-
dc.subject.keywordNDM-
dc.subject.keywordPerformance-
dc.subject.keywordXpert Carba-R v.2-
dc.contributor.alternativeNameChoi, Jun Yong-
dc.contributor.affiliatedAuthor최준용-
dc.contributor.affiliatedAuthor용동은-
dc.contributor.affiliatedAuthor용동은-
dc.citation.volume40-
dc.citation.number3-
dc.citation.startPage209-
dc.citation.endPage215-
dc.identifier.bibliographicCitationANNALS OF LABORATORY MEDICINE, Vol.40(3) : 209-215, 2020-05-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers

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