Evaluation of the "AMR Direct Flow Chip Kit" DNA microarray for detecting antimicrobial resistance genes directly from rectal and nasopharyngeal clinical samples upon ICU admission.

INTRODUCTION: Prompt detection of antibiotic resistance genes in healthcare institutions is of utmost importance in tackling the spread of multi-drug resistant micro-organisms. We evaluated the Antimicrobial Resistance (AMR) Direct Flow Chip Kit versus phenotypic screening assays for rectal and nasopharyngeal specimens upon ICU admission. METHODS: A total of 184 dual specimens (92 rectal and 92 nasopharyngeal swabs) from 92 patients were collected from 11/2017 to 8/2018. All swabs were subjected to both AMR and phenotypic tests according to their origin. The degree of agreement of the two methods was assessed by the kappa coefficient. RESULTS: The kappa coefficient showed perfect agreement for MRSA, ESBLs, oxacillinases and vancomycin resistance genes (1.000, p<0.01) and very good agreement for mecA-positive CoNS, KPC-carbapenemases and metallo-beta-lactamases (0.870, p<0.01; 0.864, p<0.01; and 0.912, p<0.01, respectively). CONCLUSION: The AMR Direct Flow Chip Kit is a useful alternative to phenotypic testing for rapid detection of resistance markers.

Evaluation of the “AMR Direct Flow Chip Kit” DNA microarray for detecting antimicrobial resistance genes directly from rectal and nasopharyngeal clinical samples upon ICU admission / Evaluación de la micromatriz de ADN «AMR Direct Flow Chip Kit» para la detección de genes de resistencia antimicrobiana directamente de muestras clínicas rectales y nasofaríngeas en el momento del ingreso en la UCI

Introduction: Prompt detection of antibiotic resistance genes in healthcare institutions is of utmost importance in tackling the spread of multi-drug resistant micro-organisms. We evaluated the Antimicrobial Resistance (AMR) Direct Flow Chip Kit versus phenotypic screening assays for rectal and nasopharyngeal specimens upon ICU admission. Methods: A total of 184 dual specimens (92 rectal and 92 nasopharyngeal swabs) from 92 patients were collected from 11/2017 to 8/2018. All swabs were subjected to both AMR and phenotypic tests according to their origin. The degree of agreement of the two methods was assessed by the kappa coefficient. Results: The kappa coefficient showed perfect agreement for MRSA, ESBLs, oxacillinases and vancomycin resistance genes (1.000, p<0.01) and very good agreement for mecA-positive CoNS, KPC-carbapenemases and metallo-beta-lactamases (0.870, p<0.01; 0.864, p<0.01; and 0.912, p<0.01, respectively). Conclusion: The AMR Direct Flow Chip Kit is a useful alternative to phenotypic testing for rapid detection of resistance markers.(AU)

Introducción: La detección rápida de genes de resistencia a antibióticos en instituciones de salud es de importancia extrema para abordar la propagación de microorganismos multi-resistentes. Evaluamos el Antimicrobial Resistance Direct Flow Chip (AMR) versus los ensayos de detección fenotípica para muestras rectales y nasofaríngeas al ingreso en la UCI. Métodos: Se recogieron 184 muestras duales (92 rectales y 92 nasofaríngeos) de 92 pacientes durante 11/2017-8/2018. Todos los hisopos se sometieron a pruebas de AMR y fenotípicas según su fuente. El grado de acuerdo de los 2 métodos fue evaluado por el coeficiente kappa. Resultados: El coeficiente kappa mostró una concordancia perfecta para MRSA, ESBL, oxacilinasas y para genes de resistencia a vancomicina (1.000, p<0,01) y muy buena concordancia para CoNS mecA positivos, carbapenemasas KPC y metalo-beta-lactamasas (0,870, p<0,01; 0,864, p<0,01 y 0,912, p<0,01, respectivamente). Conclusión: El AMR es una alternativa útil a las pruebas fenotípicas para la detección rápida de marcadores de resistencia.(AU)

CD5+ B lymphoproliferative disorder with subsequent development of plasma cell leukaemia: Diagnostic and aetiologic reasoning.

BACKGROUND: Plasma cell myeloma (PCM) has been sporadically reported to occur simultaneously or subsequently to mature B lymphoproliferative disorders (LPDs), predominantly chronic lymphocytic leukaemia (CLL). METHODS: We describe the clinical and laboratory findings of a 69-year-old male patient who developed plasma cell leukaemia (PCL) 8 years after an initial diagnosis of a low stage CD5+ B LPD and 3 years after treatment for LPD. RESULTS: The transition from a clinically indolent B LPD to an aggressive PCM was documented by bone marrow (BM) biopsy, while flow cytometric (FC) immunophenotyping conferred additional information by disclosing the co-existence of both disorders in BM and the presence of abnormal monotypic PCs in peripheral blood above PCL levels. Phenotypic findings suggested a discrete clonal origin of the two disorders. CONCLUSIONS: This report of PCL development in a patient with residual CD5+ B LPD, emphasizes the need for comprehensive diagnostic evaluation of such cases and scrutiny of their aetiological relationship, including FC immunophenotyping due to its high analytical sensitivity and multiparametric capacity compared to morphology or immunohistochemistry alone. © 2017 International Clinical Cytometry Society.