Evaluation of the Xpert Carba-R molecular rapid test in the active search for carbapenem-resistant bacteria in hospitalized patients

• Grant number: 20/16662-6
• Support Opportunities: Research Grants - Research in Public Policies
• Start date: February 01, 2023
• End date: January 31, 2025
• Field of knowledge: Biological Sciences - Microbiology - Biology and Physiology of Microorganisms
• Principal Investigator: Maria Cecília Cergole Novella
• Grantee: Maria Cecília Cergole Novella
• Host Institution: Instituto Adolfo Lutz (IAL). Coordenadoria de Controle de Doenças (CCD). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Andréia Moreira dos Santos Carmo ; Ivana Barros de Campos ; Jaqueline Maria Lima Gerbase
• Associated research grant: 17/50333-7 - Institutional research development plan of the Instituto Adolfo Lutz (PDIp), AP.PDIP
• Associated scholarship(s): 24/10583-8 - Analysis of the diagnostic accuracy of the rapid molecular test Xpert Carba-R in clinical and biological requests at the IAL of Santo André, BP.TT; 23/05126-4 - Analysis of the diagnostic accuracy of the rapid molecular test Xpert Carba-R in clinical and biological requests at the IAL of Santo André, BP.TT

Abstract

The present research project on public policies framed by the Development Plan of State Research Institutes by the São Paulo Research Foundation (Process 2017/50333-7) aims to evaluate the presence of bacterial genes that confer resistance to carbapenems in clinical samples from patients on admission or hospitalized at Hospital de Clínicas Doutor Radamés Nardini (Nardini Hospital) in the municipality of Mauá, state of São Paulo. The Xpert Carba-R molecular rapid test will be used to detect three classes, KPC (class A), IMP, NDM e VIM (class B1) and OXA-48 (class D), common of carbapenem resistance genes (blaKPC, blaNDM, blaVIM, blaIMP and blaOXA-48 genes) and compared to bacterial culture and antimicrobial sensitivity test. From clinical surveillance samples, two swabs will be collected from each site according to the medical criteria and the Hospital Infection Control Commission (HICC) of the hospital. The first surveillance swab will be sent to the clinical analysis laboratory that serves the Nardini Hospital for culture processing and sensitivity testing. The second swab will be sent to the Regional Laboratory Center of the Adolfo Lutz Institute of Santo André VIII (ALI Santo André) for processing the Xpert Carba-R. With the evaluation of the obtained data, information on the feasibility of using a test modality that allows reducing the time of diagnosis can be extracted, as well as obtaining data on the cost of the Xpert Carba-R methodology to support studies of the procedure's cost-utility. The approach is of great relevance in public health, as it will allow for the rapid isolation of cases, monitoring of contacts, monitoring of the clinical evolution of these patients even before their illness, access to treatments and therapies contributing to the interruption of the transmission chain, which can represent an important saving for the hospital system. (AU)