Molecular Detection of Multi-Drug Resistant Organism (MDRO) Colonization in a High Risk Patient Population
Methods: Prospective surveillance for nasal and perianal MDRO colonization was instituted over a 3 month period in pts admitted to the Children’s National Medical Center oncology (onc) and stem-cell transplant (SCT) wards. MDRO was defined as Methicillin Resistant Staphylococcus aureus(MRSA), Vancomycin-Resistant Enterococcus (VRE), Extended-spectrum Beta-lactamase producing gram negatives (ESBL), and Carbapenem-resistant Enterobacteriaceae (CRE). Enrolled subjects were subsequently monitored for 3-6 months for presence of invasive infection and any correlation with colonization. Nasal and perianal E-swabs were simultaneously analyzed using standard culture-based screening methods, as well as Acuitas MDRO GeneTest molecular screen.
Results: Forty-eight pts were enrolled, from whom 42 perianal and 32 nasal swabs were obtained. Using standard culture-based screening methodology, 14/42 (33%) perianal and 0/32 (0%) nasal swabs screened positive for possible MDRO. Acuitas molecular screen and subsquent standard culture and susceptibility test confirmed 4 of these 14 as actual MDRO (4/42;10%); 3 VRE (VanA) and 1 ESBL (CTX-M). Three to six month follow-up revealed no MDRO invasive infections in the study cohort. Non-MDRO invasive infections were identified in 10/48 (21%) subjects due to Bacillus, Klebsiella (IBL), Micrococcus, Pseudomonas, rapid growing Mycobacteria, Staphylococcus aureus, and Streptococcus viridans. Eight of 10 infected subjects were not previously colonized with any pathogen; 1 was colonized with different pathogens, and 1 was both colonized and infected with Pseudomonas, but with differing susceptibilities.
Conclusion: Acuitas molecular screen and standard culture accurately identified and excluded MDRO colonization in onc and SCT pts. Colonization with non-MDRO or MDRO pathogens did not predict likelihood or etiology of subsequent invasive infection.
OpGen Inc.: Grant Investigator, Grant recipient
T. Walker, OpGen Inc.: Employee and Shareholder, Salary
E. Perez, None
J. Campos, OpGen Inc: Grant Investigator, Grant recipient
R. Debiasi, opgen: Grant Investigator, Grant recipient
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