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dc.contributor.authorRomo Ibáñez, Álvaro
dc.contributor.authorCalatrava Hernández, Elisabeth
dc.contributor.authorGutiérrez Soto, Blanca
dc.contributor.authorPérez Ruiz, Mercedes
dc.contributor.authorNavarro-Marí, José María
dc.contributor.authorGutiérrez Fernández, José
dc.identifier.citationRomo-Ibáñez Á, Calatrava-Hernández E, Gutiérrez-Soto B, Pérez-Ruiz M, Navarro-Marí JM, GutiérrezFernández J. High clinical impact of rapid susceptibility testing on CHROMID ESBL® medium directly from swabs. Ann Transl Med 2020;8(9):604. [doi: 10.21037/atm.2020.02.158]es_ES
dc.descriptionThe authors are grateful to the Andalusian Molecular Typing Laboratory of the Spanish PIRASOA Program for the genetic studies of the clinical isolates.es_ES
dc.description.abstractBackground: Antibiotic resistance is a serious public health challenge exacerbated by the widespread use of β-lactam and glycopeptide antibiotics. The identification of resistances is crucial, and CHROMID ESBL medium has been developed to detect enterobacteria with extended-spectrum β-lactamases (ESBL). The objective of this study was to evaluate the potential of this medium to detect other types of resistant bacteria. Methods: Vancomycin, cefoxitin, imipenem, and cefepime disks were used to measure growth on CHROMID ESBL medium of β-lactam-resistant Gram-negative (83 with ESBL, 57 with carbapenemases, 35 with AmpC and 3 Stenotrophomonas maltophilia) and Gram-positive [37 vancomycin-susceptible (vancoS) microorganisms and 21 vancomycin-resistant (vancoR) Enterococcus faecium] clinical isolates (retrospective study) and colonization by the aforementioned bacteria (prospective study), using 649 rectal swabs, 314 pharyngeal swabs, and 44 swabs from other localizations. Results: Retrospective study: species grown on the medium exhibited different colors. Growth on the medium was observed for: all ESBL enterobacteria, which were susceptible to imipenem and cefoxitin; 95% of isolates with carbapenemases, mostly resistant to imipenem; 80% of those with AmpC; 86% of vancoR E. faecium isolates; and 42% of vancoS E. faecalis isolates, with large growth inhibition halos around the vancomycin disk. Prospective study: vancoR E. faecium, ESBL Klebsiella, Pseudomonas with carbapenemases, A. baumannii (mostly from rectal swabs), S. maltophilia, Achromobacter xylosoxidans, and Burkholderia cenocepacia (mostly from pharyngeal swabs) were isolated from the 246 positive samples. Conclusions: CHROMID ESBL medium permitted the differential growth of Gram-negative bacteria, many with ESBL and carbapenemases. ESBL enterobacteria were susceptible to imipenem, carbapenemaseproducing microorganisms grew around the imipenem disk, and vancoR E. faecium was isolated on the medium. Results of the prospective study demonstrate the potential clinical relevance of this medium. S. maltophilia was more frequently detected with pharyngeal swabs and ESBL Klebsiella, A. baumannii, and Pseudomonas with rectal swabs.es_ES
dc.publisherAnnals of Translational Medicinees_ES
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 España*
dc.subjectMultiresistant bacteriaes_ES
dc.subjectChromogenic mediaes_ES
dc.subjectCHROMID ESBL mediumes_ES
dc.titleHigh clinical impact of rapid susceptibility testing on CHROMID ESBL® medium directly from swabses_ES

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