Table 2.
Overview of clinical studies evaluating chromogenic media for detection of ESBL producers and CREa
| Chromogenic medium/use | Sample(s) (n) | Proportion of samples harboring ESBL producers/carbapenem resistant strains in total tested samples (%) | Incubation time (h) | Comparator(s) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Reference |
|---|---|---|---|---|---|---|---|---|---|
| ESBL GNB detection | |||||||||
| chromID ESBL | Fecal (344) | 59/528 (11) | 24 | Brilliance ESBL, MAC + CAZ (30 μg) | 94.9 | 95.5 | 70.8 | 98.2 | 10 |
| Respiratory tract (134) | |||||||||
| Wound, urine, vaginal, blood (50) | |||||||||
| Fecal (500) | 41/500 (8.2) | 24 | MAC + CAZ (1 μg/ml), | 100 | 94.8 | 63 | 100 | 18 | |
| MAC + CTX (1 μg/ml) | |||||||||
| Stool (186) | 17/256 (6.6) | 24 | CHROMagar ESBL | 88.2 | 92.9 | 46.9 | 99.1 | 23 | |
| Urine (48) | |||||||||
| Sputum (12) | |||||||||
| Wound (10) | |||||||||
| Rectal swab (468) | 32/765 (4.2) | 24 | BLSE | 88 | 94.4 | 38.7 | 99.6 | 22 | |
| Urine (255) | 48 | 94 | 90.5 | 28.4 | 99.9 | ||||
| Pulmonary aspiration (42) | |||||||||
| Fecal (561) | 37/644 (5.7) | 18–24 | MAC + CAZ (2 μg/ml) | 97.7 | 90.4 | ND | ND | 9 | |
| Lower respiratory tract (63) | |||||||||
| Wound, ear/nose/throat (20) | |||||||||
| CHROMagar ESBL | Stool (186) | 17/256 (6.6) | 24 | chromID ESBL | 100 | 93.3 | 51.5 | 100 | 23 |
| Urine (48) | |||||||||
| Sputum (12) | |||||||||
| Wound (10) | |||||||||
| Brilliance ESBL | Fecal (344) | 59/528 (11) | 24 | chromID ESBL, MAC + CAZ (30 μg) | 94.9 | 95.7 | 73.7 | 99.3 | 10 |
| Respiratory tract (134) | |||||||||
| Wound, urine, vaginal, blood (50) | |||||||||
| CRE detection | |||||||||
| CHROMagar KPC/Colorex KPC | |||||||||
| Rectal swab (139) | 33/139 (24) | 24 | MAC + IPM (1 μg/ml), | 84.9 | 88.7 | 70 | 95 | 1 | |
| MAC + IPM, MEM and ERT disks (10 μg) | |||||||||
| Rectal swab (126) | 46/126 (36.5) | 24 and 48 | MAC+ IPM (1 μg/ml) | 97.8 | 100 | 100 | 98.8 | 17 | |
| Stool (200) | 37/200 (18.5) | 20 | ID Carba | 97 | 96 | 71.9 | 25.8 | 19 | |
| Rectal swab (122) | 41/122 (33.6) | 24 | MAC + IPM, MEM and ERT disks (10 μg) | 100 | 98.4 | ND | ND | 24 | |
| ID Carba | Stool (200) | 37/200 (18.5) | 20 | Colorex KPC | 100 | 93 | 78.8 | 52.9 | 19 |
a
CRE, carbapenem-resistant Enterobacteriaceae; PPV, positive predictive value; NPV, negative predictive value; MAC, MacConkey agar; CAZ, ceftazidime; CTX, cefotaxime; IPM, imipenem; MEM, meropenem; ERT, ertapenem; ND, not described.