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To elaborate a new national challenge panel of resistant GNB/GPC strains for the validation of routine antimicrobial susceptibility testing (AST) methods, an interlaboratory evaluation was organized. Results of 12 well-characterized MDR strains tested by 9 laboratories using local disk diffusion (DD) and automated AST (AUST) methods were compared to the reference broth microdilution. Overall categorical agreements (CA) ranged from 70% to 100% for both DD and AUST and were > 90% for all but one strain for all antibiotics. Our multicenter AST study showed good reproducibility and the panel can be used as national resistant reference strains for routine AST validation.

Hypervirulent Klebsiella pneumoniae (hvKp) raised concern worldwide. We studied 22 hvKp clinical invasive isolates referred to the Belgian national reference laboratory between 2014 and 2020. Sixty-four percent of the isolates expressed K2 capsular serotype and belonged to 7 different MLST lineages, while 32% expressed K1 (all belonging to ST23) and were associated with liver abscesses. Primary extra-hepatic infections were reported in 36% and sepsis for 95% of the patients with 30% of deaths. Improved clinical and microbiological diagnostics are required as hvKp may represent an underestimated cause of community-acquired invasive infections in Belgium.

Carbohydrate antigen 19-9 (CA 19-9) is a biological marker used to diagnose and monitor the progression of various cancers. Elevated CA 19-9 has also been sporadically observed in Helicobacter pylori infected patients. Similar to H. pylori, animalhosted non-H. pylori Helicobacter (NHPH) species can induce gastroduodenal lesions in humans. We report the first case of CA 19-9 elevation related to H. suis gastritis and its normalisation after eradication. A CA 19-9 screening prescribed as part of a regular check up by the general practitioner was found elevated in a 68-year-old man presenting chronic dyspeptic symptoms. Medical investigations were negative for presence of neoplasia or biliary obstruction. Upper gastrointestinal endoscopy confirmed the presence of chronic gastritis and H. suis was identified in gastric biopsies. The standard treatment for H. pylori successfully eradicated H. suis with normalisation of CA 19-9 levels. In addition to H. pylori, infection with NHPH species should be considered as an additional cause of elevated CA19-9.

In order to elaborate a new national challenge panel of resistant Gram-negative bacilli and Gram-positive cocci strains for the validation of routine antimicrobial susceptibility testing (AST) methods, an interlaboratory evaluation was organised. The results of 12 well-characterised multidrug-resistant strains tested by nine laboratories using local disk diffusion (DD) and automated AST (AUST) methods were compared with the reference broth microdilution method. Overall categorical agreement ranged from 70% to 100% both for DD and AUST and was >90% for all but one strain for all antibiotics. Our multicentre AST study showed good reproducibility and the panel can be used as national resistant reference strains for routine AST validation.

This study evaluated the performance of the Novodiag CarbaR+ an automated qualitative nucleic acid-based diagnostic assay detecting the , , , , , , , , and IS1 associated carbapenemase genes and colistin resistance gene from clinical isolates or directly from rectal swabs. CarbaR+ was evaluated on 201 clinical isolates and on 100 rectal swabs (80 selected swabs from patients that were evaluated by culture method and/or Xpert Carba-R assay and 20 spiked samples). PCR-sequencing on colonies was considered as the gold standard. The CarbaR+ detected all the variants of the targeted resistance genes (39 , 30 , 20 , 19 , 15 , 19 , 13 , 4 , 8 IS1-, and 3 -like genes) with sensitivity and specificity of 98.2% and 99.7%, respectively. On the 80 rectal swabs, 71 CarbaR+ results were fully concordant with the results on selective culture media (66 positive samples with 1 to 3 carbapenemases and 5 negative samples). In eight rectal swabs, CarbaR+ identified additional carbapenemase genes. One false negative result with an producing-OXA-181 was observed and one CarbaR+ result for OXA-48 was in agreement with Xpert Carba-R assay, without growth on culture media. A concordance of 100% was observed on spiked samples. Novodiag CarbaR+ is a random-access fully automated system that achieves excellent performances for the detection of carbapenemase and/or colistin resistance determinants either from cultured clinical isolates or directly from rectal swabs in 80 minutes.

Our aim was to prospectively assess the antibiotic resistance rates in strains in Europe in 2018 and to study the link between antibiotic consumption in the community and resistance levels in the different countries. The proportion of primary antibiotic resistance cases of and their corresponding risk factors were investigated in 24 centres from 18 European countries according to a standardised protocol. Data on antibiotic consumption in the community were collected for the period 2008-2017. The link between antibiotic consumption and resistance data was assessed using generalised linear mixed models. The model with the best fit was selected by means of the Akaike Information Criterion. resistance rates for the 1211 adult patients included were 21.4% for clarithromycin, 15.8% for levofloxacin and 38.9% for metronidazole and were significantly higher in Central/Western and Southern than in the Northern European countries.The best model fit was obtained for the Poisson distribution using 2013 consumption data. A significant association was found between clarithromycin resistance and consumption in the community of macrolides (p=0.0003) and intermediate-acting macrolides (p=0.005), and between levofloxacin resistance and consumption of quinolones (p=0.0002) and second-generation quinolones (p=0.0003). This study confirms the positive correlation between macrolide and quinolone consumption in the community and corresponding resistance in European countries. Hence, treatment with clarithromycin and levofloxacin should not be started without susceptibility testing in most European countries.

The current reliable recommended test for COVID-19 diagnosis is RT-qPCR. Rapid antigen test devices could be useful as they are less expensive, faster without the need of specialized laboratories to perform the test. We report the performances of 2 rapid immunochromatographic antigen testing devices compared to RT-qPCR for SARS-CoV-2 detection in clinical samples. We carried out a lateral-flow tests study on 401 nasopharyngeal swab samples from non-duplicated suspected COVID-19 subjects. An equal volume of UTM-containing samples (dilution ratio = 1:15) were added to manufacturer's extraction buffer solution (dilution ratio = 1:2) and analyzed on BioSpeedia COVID19Speed-Antigen Test and on Abbott Panbio COVID-19 Ag Rapid Test, devices. Qualitative results were compared to those obtained by the RT-qPCR (Allplex™ SARS-CoV-2 Assay Seegene). Based on our data, overall sensitivity for BioSpeedia and Panbio devices were estimated at 65.5 and 75.0 %, respectively. The sensitivity was greater for cycle threshold values less than 25 achieving 90.4 and 96.8 for BioSpeedia and Panbio devices, respectively. A perfect specificity of 100.0% was observed for both devices. BioSpeedia and Panbio, as rapid antigen tests with excellent sensitivity to detect high viral loads, appeared to be reliable alternatives to RT-qPCR especially valuable when molecular testing capacity may be saturated by overflow of samples. Given the high specificity of devices, a positive result would not require confirmation by a molecular test and would therefore allow a faster management of COVID-19-positive patients. This article is protected by copyright. All rights reserved.