The emergence and global dissemination of multi-drug resistant organisms with the potential to cause untreatable infections has prompted the World Health Organisation (WHO) to call for a global action plan to combat antimicrobial resistance. The Australian government is an active participant, developing Australia’s First National Antimicrobial Resistance Strategy 2015-2019. The initiative has brought together states and territories, hospital administrators, the pharmaceutical industry, agriculture and veterinary professionals in a ‘One Health’ approach.
In response to this initiative and an increasing number of carbapenemase-producing Enterobacteriaceae (CPE) being isolated in Victoria, the Victorian Government has recognised the important role that health care settings play in this public health threat. The Department of Health and Human Services released the Victorian guideline on carbapenemase-producing Enterobacteriaceae for health services in December 2015. The document outlines a surveillance strategy aimed at detecting all cases of CPE in Victoria and describes the minimum CPE screening that health services are required to undertake to achieve this objective.
To determine the most suitable screening method for Eastern Health, the Microbiology Department evaluated five methods for CPE detection: chromID®CARBA SMART agar (bioMérieux); Brilliance™CRE Agar (OXOID); RAPIDEC®CARBA NP (bioMérieux); Xpert®Carba-R (Cepheid) and the Carbapenem Inactivation Method.
We report the results obtained from the evaluation of these five test methods and discuss the rationale for determining the best method for our laboratory to screen for CPE.