RESUMO
The usefulness of the combined use of MALDI-TOF MS from a subculture with 3-5h of incubation and the BCID2 panel (FilmArray) for the identification of microorganisms from positive blood cultures and its importance in the adjustment of antimicrobial therapy was analyzed. Overall identification with BCID2 was 90.4% (142/157) and with Maldi-TOF MS 83.4% (131/157) (p=0.0858); in 23 polymicrobial episodes (47 strains), the BCID2 panel identified 45 (95.7%) and MALDI-TOF MS 24 (51.1%) (p<0.0000). BCID2 detected the presence of the resistance genes mecA/C (n=16), blaKPC (n=8); blaCTX-M (n=17), blaNDM (n=8), blaOXA-48 (n=1), and vanA/B (n=2). The median time to report a result was 2.0h for BCID2 and 4.0h for MALDI-TOF MS (p<0.0000). Of 124 episodes analyzed, the rapid result of BCID2 led to 82.3% (102/124) therapeutic changes.
Assuntos
Bacteriemia , Humanos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Bacteriemia/diagnósticoRESUMO
During 2020-2021, countries in Latin America and the Caribbean reported clinical emergence of carbapenemase-producing Enterobacterales that had not been previously characterized locally, increased prevalence of carbapenemases that had previously been detected, and co-production of multiple carbapenemases in some isolates. These increases were likely fueled by changes related to the COVID-19 pandemic, including empirical antibiotic use for potential COVID-19-related bacterial infections and healthcare limitations resulting from the rapid rise in COVID-19 cases. Strengthening antimicrobial resistance surveillance, epidemiologic research, and infection prevention and control programs and antimicrobial stewardship in clinical settings can help prevent emergence and transmission of carbapenemase-producing Enterobacterales.