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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 209 - 215 (7page)
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초록· 키워드
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Background: 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.
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참고문헌 (16)
참고문헌 신청
WHO / 2017 / Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics
Landman D / 2005 / Evaluation of techniques for detection of carbapenem-resistant Klebsiella pneumoniae in stool surveillance cultures / J Clin Microbiol 43:5639~5641
김도균 / 2016 / Xpert CARBA-R Assay for the Detection of Carbapenemase-Producing Organisms in Intensive Care Unit Patients of a Korean Tertiary Care Hospital / Annals of Laboratory Medicine 36(2):162~165
Tato M / 2016 / Multisite evaluation of Cepheid Xpert Carba-R assay for detection of carbapenemase-producing organisms in rectal swabs / J Clin Microbiol 54:1814~1819
Dortet L / 2016 / Improvement of the Xpert Carba-R Kit for the detection of carbapenemase-producing Enterobacteriaceae / Antimicrob Agents Chmother 60:3832~3837
Landman D / 2005 / Evaluation of techniques for detection of carbapenem-resistant Klebsiella pneumoniae in stool surveillance cultures / J Clin Microbiol 43:5639~5641
김도균 / 2016 / Xpert CARBA-R Assay for the Detection of Carbapenemase-Producing Organisms in Intensive Care Unit Patients of a Korean Tertiary Care Hospital / Annals of Laboratory Medicine 36(2):162~165
Tato M / 2016 / Multisite evaluation of Cepheid Xpert Carba-R assay for detection of carbapenemase-producing organisms in rectal swabs / J Clin Microbiol 54:1814~1819
Dortet L / 2016 / Improvement of the Xpert Carba-R Kit for the detection of carbapenemase-producing Enterobacteriaceae / Antimicrob Agents Chmother 60:3832~3837
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