Diagnostic characteristics of the Rapid ESBL NP® test directly on urine samples in patients with a urinary tract infection

AIM: To determine the suitability of the Rapid ESBL NP test for the rapid detection of extended spectrum beta-lactamase (ESBL) in clinical urine samples of patients with a urinary tract infection. BACKGROUND: The rise of antibiotic resistance in Gram-negative bacteria threatens successful treatment...

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Main Authors: Marit Bot, Jacky Flipse, Sabien Bongers, Jacobien Hoogerwerf, Jaap Ten Oever, Heiman Wertheim, Maurits van Meer
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S221371652400290X
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author Marit Bot
Jacky Flipse
Sabien Bongers
Jacobien Hoogerwerf
Jaap Ten Oever
Heiman Wertheim
Maurits van Meer
author_facet Marit Bot
Jacky Flipse
Sabien Bongers
Jacobien Hoogerwerf
Jaap Ten Oever
Heiman Wertheim
Maurits van Meer
author_sort Marit Bot
collection DOAJ
description AIM: To determine the suitability of the Rapid ESBL NP test for the rapid detection of extended spectrum beta-lactamase (ESBL) in clinical urine samples of patients with a urinary tract infection. BACKGROUND: The rise of antibiotic resistance in Gram-negative bacteria threatens successful treatment of infections, increasing the need for last-resort antibiotics, and consequently the risk of overtreatment. Rationalising the use of these last-resort antibiotics can be done using rapid diagnostics for the detection of ESBL, such as the Rapid ESBL NP® test, which can determine ESBL-activity within one hour. METHODS: A total of 218 urine samples were collected from two Dutch hospitals, of which 67 contained ESBL-producing bacteria, 101 contained non ESBL-producing bacteria and 50 were negative controls. Culture-based techniques and the Rapid ESBL NP® test were used to confirm the presence of ESBL-producing bacteria. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated with 95% confidence intervals. RESULTS: The Rapid ESBL NP® test gave 16 (7.3%) non-interpretable results. After excluding these non-interpretable results, the test had a sensitivity, specificity, PPV and NPV of 96.8% (95%CI: 89.0-99.6), 100% (97.4-100.0), 100.0% (94.1-100.0) and 98.6% (94.7-99.6), respectively. When non-interpretable tests were seen as negative, these values became 91.0% (95%CI: 81.5-96.6), 100% (97.6-100.0), 100% (94.1-100.0) and 96.2% (92.1-98.2), respectively. CONCLUSIONS: The Rapid ESBL NP® test can be a suitable screening tool for ESBL-producing bacteria in clinical urine samples while awaiting the more accurate culture-based results and further antimicrobial susceptibility pattern, ensuring more accurate initial prescription of last-resort antibiotics.
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spelling doaj-art-b22fb402d05c4e17b31c92a444b79d542025-08-20T02:53:21ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-01393610.1016/j.jgar.2024.10.113Diagnostic characteristics of the Rapid ESBL NP® test directly on urine samples in patients with a urinary tract infectionMarit Bot0Jacky Flipse1Sabien Bongers2Jacobien Hoogerwerf3Jaap Ten Oever4Heiman Wertheim5Maurits van Meer6Department of Medical Microbiology and Immunology, Rijnstate hospital, Arnhem, the NetherlandsDepartment of Medical Microbiology and Immunology, Rijnstate hospital, Arnhem, the NetherlandsDepartment of Medical Microbiology and Immunology, Rijnstate hospital, Arnhem, the NetherlandsDepartment of Internal Medicine, Raboud University Medical Center, Nijmegen, the NetherlandsDepartment of Internal Medicine, Raboud University Medical Center, Nijmegen, the NetherlandsDepartment of Medical Microbiology, Radboud University Medical Center, Nijmegen, the NetherlandsDepartment of Medical Microbiology and Immunology, Rijnstate hospital, Arnhem, the NetherlandsAIM: To determine the suitability of the Rapid ESBL NP test for the rapid detection of extended spectrum beta-lactamase (ESBL) in clinical urine samples of patients with a urinary tract infection. BACKGROUND: The rise of antibiotic resistance in Gram-negative bacteria threatens successful treatment of infections, increasing the need for last-resort antibiotics, and consequently the risk of overtreatment. Rationalising the use of these last-resort antibiotics can be done using rapid diagnostics for the detection of ESBL, such as the Rapid ESBL NP® test, which can determine ESBL-activity within one hour. METHODS: A total of 218 urine samples were collected from two Dutch hospitals, of which 67 contained ESBL-producing bacteria, 101 contained non ESBL-producing bacteria and 50 were negative controls. Culture-based techniques and the Rapid ESBL NP® test were used to confirm the presence of ESBL-producing bacteria. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated with 95% confidence intervals. RESULTS: The Rapid ESBL NP® test gave 16 (7.3%) non-interpretable results. After excluding these non-interpretable results, the test had a sensitivity, specificity, PPV and NPV of 96.8% (95%CI: 89.0-99.6), 100% (97.4-100.0), 100.0% (94.1-100.0) and 98.6% (94.7-99.6), respectively. When non-interpretable tests were seen as negative, these values became 91.0% (95%CI: 81.5-96.6), 100% (97.6-100.0), 100% (94.1-100.0) and 96.2% (92.1-98.2), respectively. CONCLUSIONS: The Rapid ESBL NP® test can be a suitable screening tool for ESBL-producing bacteria in clinical urine samples while awaiting the more accurate culture-based results and further antimicrobial susceptibility pattern, ensuring more accurate initial prescription of last-resort antibiotics.http://www.sciencedirect.com/science/article/pii/S221371652400290XRapid diagnosticsESBLurinary tract infection
spellingShingle Marit Bot
Jacky Flipse
Sabien Bongers
Jacobien Hoogerwerf
Jaap Ten Oever
Heiman Wertheim
Maurits van Meer
Diagnostic characteristics of the Rapid ESBL NP® test directly on urine samples in patients with a urinary tract infection
Journal of Global Antimicrobial Resistance
Rapid diagnostics
ESBL
urinary tract infection
title Diagnostic characteristics of the Rapid ESBL NP® test directly on urine samples in patients with a urinary tract infection
title_full Diagnostic characteristics of the Rapid ESBL NP® test directly on urine samples in patients with a urinary tract infection
title_fullStr Diagnostic characteristics of the Rapid ESBL NP® test directly on urine samples in patients with a urinary tract infection
title_full_unstemmed Diagnostic characteristics of the Rapid ESBL NP® test directly on urine samples in patients with a urinary tract infection
title_short Diagnostic characteristics of the Rapid ESBL NP® test directly on urine samples in patients with a urinary tract infection
title_sort diagnostic characteristics of the rapid esbl np r test directly on urine samples in patients with a urinary tract infection
topic Rapid diagnostics
ESBL
urinary tract infection
url http://www.sciencedirect.com/science/article/pii/S221371652400290X
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