{
    "abstract": "The aims of this study were: (i) to assess the ability of the meropenem screening breakpoint as part of the screening rapid antimicrobial susceptibility testing (sRAST) of EUCAST for the detection of OXA-48 carbapenemase-producing Klebsiella pneumoniae directly from positive blood cultures (BCs); and (ii) to evaluate the inclusion of ertapenem and temocillin discs into the sRAST to enhance the detection of OXA-48-producing isolates.\nBC bottles were spiked with a total of 117 K. pneumoniae isolates, including 77 previously characterized OXA-48 producers and 40 non-OXA-48 producers. Disc diffusion assays were directly performed from positive BCs with meropenem (10 \u00b5g), ertapenem (10 \u00b5g) and temocillin (30 \u00b5g) discs, and inhibition zones were manually measured after 4, 6 and 8 h of incubation. The screening cut-off values of sRAST were applied to evaluate their capability in detecting OXA-48-producing isolates. Receiver operating characteristic curves were constructed to illustrate the performance efficacy of the disc diffusion assays to detect OXA-48 producers.\nThe meropenem cut-off values of sRAST only detected 90.91% of the OXA-48-producing isolates after 6 and 8 h of incubation. With the proposed cut-off points for ertapenem [<19 mm (4/6 h) and <20 mm (8 h)] and temocillin [<10 mm (4 h) and <11 mm (6/8 h)], all OXA-48-positive isolates were detected without any false-positive results at any reading time.\nIn healthcare settings with a high prevalence of OXA-48 producers, the inclusion of ertapenem and temocillin discs in the sRAST procedure may improve the detection of OXA-48-producing K. pneumoniae isolates directly from positive BCs, providing reliable results after only a 4 h incubation period.",
    "authors": [
        {
            "affiliation": "Servicio de Microbiolog\u00eda, Hospital Valle del Nal\u00f3n, Langreo, Spain.\nServicio de Microbiolog\u00eda, Hospital Universitario de Cabue\u00f1es, Gij\u00f3n, Spain.",
            "firstname": "Bel\u00e9n",
            "initials": "B",
            "lastname": "Fern\u00e1ndez-Caso"
        },
        {
            "affiliation": "Grupo de Neoplasias Hematol\u00f3gicas, Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.\nGrupo de Microbiolog\u00eda Traslacional, Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.",
            "firstname": "Pilar",
            "initials": "P",
            "lastname": "Lumbreras-Iglesias"
        },
        {
            "affiliation": "Grupo de Microbiolog\u00eda Traslacional, Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.\nDepartamento de Biolog\u00eda Funcional, \u00c1rea de Microbiolog\u00eda, Universidad de Oviedo, Oviedo, Spain.",
            "firstname": "M Rosario",
            "initials": "MR",
            "lastname": "Rodicio"
        },
        {
            "affiliation": "Grupo de Microbiolog\u00eda Traslacional, Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.\nServicio de Microbiolog\u00eda, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.\nResearch & Innovation, Artificial Intelligence and Statistical Department, Pragmatech, Oviedo, Spain.",
            "firstname": "Javier",
            "initials": "J",
            "lastname": "Fern\u00e1ndez"
        },
        {
            "affiliation": "Grupo de Microbiolog\u00eda Traslacional, Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.\nServicio de Microbiolog\u00eda, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.",
            "firstname": "Carlos",
            "initials": "C",
            "lastname": "Rodr\u00edguez-Lucas"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
    "doi": "10.1093/jac/dkad406",
    "journal": "The Journal of antimicrobial chemotherapy",
    "keywords": [],
    "methods": null,
    "publication_date": "2023-12-28",
    "pubmed_id": "38153116",
    "results": "The meropenem cut-off values of sRAST only detected 90.91% of the OXA-48-producing isolates after 6 and 8 h of incubation. With the proposed cut-off points for ertapenem [<19 mm (4/6 h) and <20 mm (8 h)] and temocillin [<10 mm (4 h) and <11 mm (6/8 h)], all OXA-48-positive isolates were detected without any false-positive results at any reading time.",
    "title": "Usefulness of inclusion of ertapenem and temocillin screening breakpoints in the EUCAST rapid antimicrobial susceptibility testing (RAST) for rapid detection of OXA-48-producing Klebsiella pneumoniae directly from positive blood cultures.",
    "xml": "<Element 'PubmedArticle' at 0x788503307e70>"
}