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Bonnet M. , Benzerara Y. , Danjean M. , Woerther P.L. , Rodriguez C. , Schilton O. , Veziris N. , Godmer A. , Pierrat G.
Microbiol Spectr . 2026 Feb 4:e0271825.
Abstract
The dissemination of multidrug-resistant Enterobacterales, particularly those resistant to third-generation cephalosporins (3GC), poses a significant public health challenge. This study evaluated the performance of the Beta-Lactamase Rapid Electrochemical Detection (BL-RED) test (CORIS BioConcept, Belgium) alongside the β-LACTA test (Bio-Rad, France), another routinely used technique in our laboratory, for the rapid detection of 3GC-resistant Enterobacterales from 4 h subcultures of positive blood cultures. A total of 178 isolates were included: 55 clinical isolates with characterized resistance mechanism and 123 isolates from positive blood cultures prospectively collected between April and July 2023. Parallel testing with the BL-RED and β-LACTA tests was performed, and the results were compared to those of conventional antibiotic susceptibility testing by disk diffusion, following the 2024 EUCAST recommendations. The sensitivity, the specificity, the observed positive predictive value, and the observed negative predictive value for 3GC resistance detection in the prospective cohort were 74%, 100%, 100%, and 95%, respectively, for both the BL-RED and β-LACTA tests. Both tests demonstrated good performance in detecting 3GC-resistant Enterobacterales, particularly those expressing common Ambler class A beta-lactamases. However, they were less effective in detecting 3GC resistance due to the presence of other Ambler class families, notably overproduced chromosomal and plasmid-mediated Ambler class C beta-lactamases. The ease of use of these tests makes them suitable for routine microbiology laboratory testing. We propose a diagnostic algorithm combining the use of either the BL-RED and β-LACTA tests with that of MALDI-TOF MS in order to initiate targeted antibiotic therapy early. IMPORTANCEAntimicrobial resistance, especially among Enterobacterales resistant to third-generation cephalosporins (3GC), represents a major public health threat. Delayed detection of these resistant pathogens can lead to inappropriate empirical antibiotic therapy, with risk of treatment failures and further spread of resistance. This study underscores the value of rapid diagnostic tools, specifically the BL-RED and β-LACTA tests, for the rapid identification of 3GC-resistant Enterobacterales directly from positive blood cultures. By enabling quicker therapeutic decision-making, these assays provide a practical solution for microbiology laboratories to enhance patient management and contribute to global efforts in mitigating the impact of antibiotic-resistant infections.
https://pubmed.ncbi.nlm.nih.gov/41636485/
Bonnet M, Godmer A, Danjean M, Woerther PL, Rodriguez C, Veziris N, Benzerara L, Pierra G
34th European Congress of Clinical Microbiology and Infectious Diseases, Infectious Diseases April 27 – 30, 2024
Bonnet M et al, 2024
M-L. Lamaison, L. Bientz, AB. Kagambega, M. Martin, C. Bébéar, V. Dubois
43e Réunion interdisciplinaire de chimiothérapie anti-infectieuse 18 - 19 décembre, 2023 Paris.
Abdallah ZB., Tamisier N., Lleres-Vadeboin M., Grattard F., Pozzetto B., Verhoeven PO., Carricajo A.
J Microbiol Methods. 2022 Dec;203:106626.
Abstract
The sensitivity of NG-test CTX-M Multi assay and BL-RED test incubated 10 min for the detection of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae was 80.6% and 90.3% respectively. Using an extended 60 min incubation with the BL-RED test, its sensitivity was increased to 100% and 60.9% for ESBL-producing and cephalosporinase-overexpressing Enterobacteriaceae respectively.
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