Rapid detection of CTX-M-type ESBLs and carbapenemases directly from biological samples using the BL-DetecTool.

BACKGROUND: Lateral flow immunoassays (LFIA) have shown their usefulness for detecting CTX-M- and carbapenemase-producing Enterobacterales (CPEs) in bacterial cultures. Here, we have developed and validated the BL-DetecTool to detect CTX-M enzymes and carbapenemases directly from clinical samples. METHODS: The BL-DetecTool is an LFIA that integrates an easy sample preparation device named SPID (Sampling, Processing, Incubation and Detection). It was evaluated in three University hospitals on urine, blood culture (BC) and rectal swab (RS) specimens either of clinical origin or on spiked samples. RS evaluation was done directly and after a 24 h enrichment step. RESULTS: The CTX-M BL-DetecTool was tested on 485 samples (154 BC, 150 urines, and 181 RS) and revealed a sensitivity and specificity of 97.04% (95% CI 92.59%-99.19%) and 99.43% (95% CI 97.95%-99.93%), respectively. Similarly, the Carba5 BL-DetecTool was tested on 382 samples (145 BC, 116 urines, and 121 RS) and revealed a sensitivity and specificity of 95.3% (95% CI 89.43%-98.47%) and 100% (95% CI 98.67%-100%), respectively. While with the Carba5 BL-DetecTool five false negatives were observed, mostly in RS samples, with the CTX-M BL-DetecTool, in addition to four false-negatives, two false-positives were also observed. Direct testing of RS samples revealed a sensitivity of 78% and 86% for CTX-M and carbapenemase detection, respectively. CONCLUSIONS: BL-DetecTool showed excellent biological performance, was easy-to-use, rapid, and could be implemented in any microbiology laboratory around the world, without additional equipment, no need for electricity, nor trained personnel. It offers an attractive alternative to costly molecular methods.

Rapid Detection of VanA/B-Producing Vancomycin-Resistant Enterococci Using Lateral Flow Immunoassay.

Vancomycin-resistant enterococci (VREs) have become one of the most important nosocomial pathogens worldwide, associated with increased treatment costs, prolonged hospital stays and high mortality. Rapid detection is crucial to reduce their spread and prevent infections and outbreaks. The lateral flow immunoassay NG-Test VanB (NG Biotech) was evaluated for the rapid detection of VanB-producing vancomycin-resistant enterococci (VanB-VREs) using 104 well-characterized enterococcal isolates. The sensitivity and specificity were both 100% when bacterial cells were grown in the presence of vancomycin used as a VanB inducer. The NG-Test VanB is an efficient, rapid and easy to implement assay in clinical microbiology laboratories for the confirmation of VanB-VREs from colonies. Together with the NG-Test VanA, they could replace the already existing tests available for the confirmation of acquired vancomycin resistance in enterococci, especially from selective media or from antibiograms, with 100% sensitivity and specificity. Rapid detection in less than 15 min will result in more efficient management of carriers and infected patients. In addition, these tests may be used for positive blood cultures, given a 3.5 h sub-culturing step on Chocolate agar PolyViteX in the presence of a 5-µg vancomycin disk, which is routinely performed in many clinical microbiology laboratories for every positive blood culture for subsequent MALDI-TOF identification of the growing bacteria.

Cardiovascular Clinical Assessment in Greyster Dogs in Bikejöring Training.

Bikejöring is a type of dryland mushing requiring high-intensity aerobic effort, with speed peaks close to 42 km/h. Greysters (crosses between the German Shorthaired Pointer and the Greyhound) often participate in such events and perform well. The objective of this comparative study was to evaluate the clinical use of non-invasive methods in assessing the cardiovascular health of 22 Greyster dogs in physical training, by determining the differences between different cardiovascular parameters before and after physical training. Blood pressure, heart rate and echocardiographic results were compared. The mean age of the dogs was 4.4 years ± 1.8% and 54.5% were female. All participating dogs regularly participated in bikejöring. Post-exercise increases were observed in systolic blood pressure (SBP), mean arterial pressure (MBP) and pulse pressure (SBPD), with diastolic blood pressure (DBP) remaining stable. Changes of clinical interest were observed in numerous echocardiographic variables such as left ventricle fractional shortening (LVFS), left ventricule ejection fraction (LVEF), E-point to septal separation (EPSS), cardiac output (CO), cardiac index (CI), posterior wall thickness at end-diastole (PWd) and major/minor axis ratio (MA/ma), including a decrease in the shortening fraction and an increase in EPSS after exercise. These clinical findings were observed in both males and females; they do not appear to be associated with dilated cardiomyopathy, but rather with a cardiovascular response to physical training. This study derives from the real interest of clinical veterinarians who care for highly trained canine athletes. It contributes to an increase in knowledge of the different cardiac adaptations of such dogs after intense exercise and serves to differentiate these from pathologic conditions.