Review: Molecular detection of extended spectrum-β-lactamase- and carbapenemase-producing Enterobacteriaceae in a clinical setting

Abstract

Enterobacteriaceae are a common source of both community- and hospital-acquired infections. The resistance of Enterobacteriaceae to β-lactam antibiotics is a major public health problem and rapid detection is essential for the proper management of infections. Not only for the initiation of the proper antimicrobial regimen but also to stop the spread of multi-resistant bacteria. In this review, molecular methods that detect extended-spectrum-β-lactamase-harboring and carbapenem-resistant Enterobacteriaceae were discussed. More specifically the performances of assays that were tested in a clinical situation were explored. When compared with conventional phenotypical methods (the gold standard) all molecular methods generated results faster and showed a higher sensitivity. Because molecular methods only detect selected genes, it is important to have good knowledge on the local gene pool. Furthermore, result need to be interpreted within a defined epidemiological context. Therefore, at this moment molecular methods should be seen as an important tool to complement rather than replace conventional methods.

Keywords: Carbapenemases; Clinical situation; ESBL; Enterobacteriaceae; Molecular detection.