, Pyoeng Gyun Choe The rise of multidrug-resistant organisms represents a serious global public health concern. In Korea, the increasing prevalence of carbapenem-resistant Enterobacterales (CRE) is particularly concerning due to the difficulties associated with treatment. Data from the Korea Global Antimicrobial Resistance Surveillance System indicate a yearly increase in CRE cases, with carbapenemase-producing Enterobacterales being the predominant type. The capacity of CRE to resist multiple broad-spectrum antibiotics leads to higher medical costs and mortality rates, underscoring the need for urgent action. Effective prevention is crucial to curbing CRE outbreaks and transmission. Antimicrobial stewardship programs (ASPs) play a key role and require commitment from healthcare professionals to minimize unnecessary antibiotic use, as well as from policymakers to ensure adherence to ASP guidelines. Given the complexity of CRE transmission, ASP efforts must be integrated with infection control strategies for maximum effectiveness. These strategies include adherence to standard and contact precautions, environmental disinfection, preemptive isolation, and comprehensive education and training for healthcare personnel. Additionally, surveillance testing for patients at high risk for CRE and the use of real-time diagnostic kits can facilitate early detection and reduce further transmission. Strategies for the prevention of CRE infection should be tailored to specific healthcare settings. Ongoing research is essential to update and refine infection control guidelines and effectively prevent CRE outbreaks.
Citations
, Naery Yang, Yihyeon Kim, Miae Lee, Sholhui Park The Xpert Carba-R Assay is a diagnostic test designed for the rapid detection and differentiation of the
The analytical limit of detection was determined with two suspensions of carbapenemase-producing
In bacterial isolates, concordant results between the Xpert Carba-R Assay and PCR were found in 20 of 21; 8 KPC, 8 NDM, 1 IMP, and 2 multiple carbapenamase genes (KPC/NDM, NDM/OXA) were detected both by Xpert Carba-R Assay and PCR. In one GES-positive isolate, Xpert Carba-R Assay showed a negative result as expected. One VIM-positive isolate tested negative by Xpert Carba-R Assay. Complete concordance was seen in rectal swab specimens: 4 specimens with KPC and 17 specimens with negative results both by Xpert Carba-R Assay and surveillance culture. Among the 10 contrived stool specimens, Xpert Carba-R Assay detected carbapenemase genes in 9 specimens as expected according to the CPE strains spiked into the contrived stool; 2 KPC, 4 NDM, 1 IMP, and 2 multiple carabapenamase genes (NDM/KPC, NDM/OXA). One VIM-positive specimen tested negative by Xpert Carba-R Assay.
In conclusion, the Xpert Carba-R Assay can be used to identify carbapenemase gene in bacterial isolates cultured from clinical specimens and detect CPE carrier using rectal swab in clinical laboratories.
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