The diagnostic accuracy of the GeneXpert ESBL- ampC prototype assay for rapid PCR-based detection of extended-spectrum beta-lactamase genes directly from urine

Sofie C. M. Tops; Claire Schapendonk; Jordy P. M. Coolen; Fred C. Tenover; Isabella A. Tickler; Willem J. G. Melchers; Heiman Wertheim

doi:10.1128/spectrum.03116-23

November 14, 2023SHILAP Revista de lepidopterologíaOpen Access

The diagnostic accuracy of the GeneXpert ESBL- ampC prototype assay for rapid PCR-based detection of extended-spectrum beta-lactamase genes directly from urine

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Key Points

To evaluate the clinical role and diagnostic value of rapid PCR-based detection of ESBL and ampC resistance genes directly from urine in complicated urinary tract infections.
Assessed a prototype PCR assay designed for rapid direct identification of beta-lactamase resistance markers in urine specimens.
Evaluated diagnostic clinical pathways across differing regional ESBL prevalence settings, modeling rule-in and rule-out strategies for empirical carbapenem prescribing.
Serves as a rule-in diagnostic tool in low-prevalence settings to guide targeted carbapenem initiation and avoid cephalosporin failure.
Functions as an early rule-out diagnostic in high-prevalence settings to enable prompt carbapenem de-escalation, lowering selective pressure for carbapenem resistance.

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Implication

Diagnostic evaluation demonstrates clinical utility of rapid PCR for urinary ESBL detection, suggesting potential to guide carbapenem therapy and limit antimicrobial resistance.

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Tops et al. (2023) studied this question.

synapsesocial.com/papers/69dd692e7808b00a4799dadc https://doi.org/10.1128/spectrum.03116-23

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The diagnostic accuracy of the GeneXpert ESBL- ampC prototype assay for rapid PCR-based detection of extended-spectrum beta-lactamase genes directly from urine

Key Points

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Implication

Abstract

Discussion

Cite This Study

The diagnostic accuracy of the GeneXpert ESBL- ampC prototype assay for rapid PCR-based detection of extended-spectrum beta-lactamase genes directly from urine

Key Points

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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