Hi all
May I know when one is at a resource limited setting but at the same time is having clusters of outbreaks by CREs, would it be wise to introduce a selective media for CRE detection amongst the screen patients such as Supracarba
or using the normal and routine media would have the same pick up rate
or there is an increase in sensitivity favouring the selective media, as such If there a difference in the pick up rate, would the difference be large enough in term of costing or perhaps turn around time to justify its introduction in the hospital. BTW we cant do PCR as of now because the cost would be huge
Hi. For what I know, and understood, of your condition, you have 2 choices:
Compare the costs of the 2 methoods, and choose.
Hoping to be helpful.
Best regards,
Ramona.
Hi, aggree with Ramona above; use BHI (5 ml) add one 10microg meropenem disc (=2micro/ml), incubate o/n. The streek on Conradi Drigalski agar/MacConkey with meropenem disc. This would give you approx. 10% more hits than conventional culture. If you also look for OXA-48 you have to cut the disc in quarters (=.5 micro/ml) as some of these have very low MIC.
Best
Dennis
To screen for CRE here we use MacConkey plates containing 1ug/mL Imipenem. This allows you to quickly screen a lot of samples without having to be making media all the time. If you get a resistant isolate back and want to know the exact MIC you could use an imipenem E-test strip.
Brain Heart Infusion Broth with Meropenem is the cheapest, protocol is given on CDC webpage on CRE
molecular assays are the most expensive and effective method for CRE screening such as FDA has been approved as one with the highest sensitivity and fast turnaround time with specific genetic information. with media the best media to use for the detection is brilliance CRE, MAC, brian hear
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