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As carbapenemase-producing Enterobacteriaceae (CPE) and extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-E) are becoming a major public health issue, there is an urgent need for accurate and fast diagnostic tests. The ELITe InGenius is a fully automated sample-to-result system designed for the extraction and detection by multiplex real-time polymerase chain reaction of carbapenemases KPC, NDM, VIM, IMP, and OXA-48–like variants and CTX-M group 1 and 9-producers from diverse sample matrices such as colonies, positive blood cultures, and rectal swabs. CRE and ESBL ELITe MGB® kits were evaluated on 153 cultured colonies of enterobacterial isolates with characterized β-lactamase content, on 30 spiked blood cultures, and the CRE kit was also evaluated on 53 clinical rectal swabs collected prospectively during a 3-month period and 10 spiked rectal swabs. CRE ELITe MGB® kit’s performances reached 100% sensitivity and 100% specificity, while for the ESBL ELITe kit, 100% sensitivity and 96.6% specificity were observed, with a sample to result of less than 3 h and a total percentage of agreement with expected results of 99.6% (255/256).

A multilocus sequence typing (MLST) scheme including 7 housekeeping genes was used to evaluate whether the current spread of multidrug-resistant Enterobacter cloacae isolates worldwide might be associated to specific successful clones. Fifty E. cloacae clinical isolates of worldwide origin, with various β-lactamase content, and recovered at different periods of time were studied. Forty-four sequence types were identified, highlighting a high clonal diversity with 3 main lineages. This study revealed that a precise identification of the isolates by sequencing of the chromosomal ampC gene of E. cloacae would provide a significant added value to improve the reliability of the MLST scheme.

An OXA-181 producing Escherichia coli isolate that went recurrently undetected directly from rectal swab sample using Xpert® Carba-R, was successfully detected using ertapenem supplemented broth enrichment followed by culture-based method. Our data suggest that implementation of culture-based methods plus enrichment might be crucial for the efficient screening of patients considered to be at “high-risk” of colonization with carbapenemase producers and who are colonized at low level.

The recently modified CHROMagar Acinetobacter medium was evaluated for detection of carbapenemase-producing Acinetobacter baumannii from spiked stools. A total of 45 Acinetobacter spp. isolates were tested. The CHROMagar Acinetobacter medium had a high sensitivity of 86.5% and a specificity of 75%. This medium is likely to be most useful for controlling outbreaks and in endemic situations.

The performance of Etest KPC and MBL strips (bioMerieux) was evaluated as compared to other phenotypic tests for detecting carbapenemases of the KPC-type and metallo-β-lactamases, respectively, on 133 well-characterized enterobacterial isolates. KPC and meropenem-containing MP/MPI Etest had high sensitivity (>92 %) and specificity (>97 %).

Comparative evaluation of the recently developed chromogenic culture medium chromID OXA-48 (bioMerieux) with chromID CARBA (bioMerieux) and SUPERCARBA showed that chromID OXA-48 and SUPERCARBA media have the highest sensitivity for detection of OXA-48 producing Enterobacteriaceae (91% and 93%) comparatively to chromID CARBA (21 %). The chromID OXA-48 has the highest specificity, with 100%, as compared to 53% and 68% for the SUPERCARBA and chromID CARBA media for detecting those OXA-48 producers.

The recently developed SUPERCARBA medium was evaluated together with 2 commercially available selective culture media containing carbapenems: CHROMagar KPC (CHROMagar) and Brilliance CRE (Oxoid, Thermofisher Scientific). A total of 142 enterobacterial isolates were tested, including 131 isolates with reduced susceptibility to carbapenems. The SUPERCARBA medium has the highest sensitivity (96.5%) (detecting virtually all carbapenemase producers including OXA-48-like producers) as compared to Brilliance CRE (76.3%) and CHROMagar KPC (43%). The specificity of the screening media was similar, ranging from 57% to 68%.