Huang, Te-Din Poirel, Laurent Bogaerts, Pierre Berhin, Catherine Nordmann, Patrice Glupczynski, Youri 2013-09-20 <strong>Objectives</strong> To assess the performance of the agar disc diffusion method for the detection of carbapenemase-producing Enterobacteriaceae (CPE) referred to the national reference laboratories (NRLs) in Belgium and France.<strong>Methods</strong> All Enterobacteriaceae isolates referred to the NRLs for the confirmation of CPE in 2012 were included. The inhibition zone diameters of meropenem, piperacillin/tazobactam and temocillin using CLSI disc diffusion methodology were recorded. Phenotypic and molecular detection of carbapenemases was performed on all isolates.<strong>Results</strong> A total of 1354 Enterobacteriaceae isolates, including 435 (32.1%) confirmed CPE isolates [OXA-48 (<em>n</em> = 323), KPC (<em>n</em> = 60), VIM (<em>n</em> = 32) and NDM (<em>n</em> = 20)] and 919 carbapenemase-negative isolates, were tested. Using recommended interpretative criteria, non-susceptibility to meropenem had poor sensitivity (52.0% by CLSI susceptibility breakpoint and 80.0% by EUCAST screening breakpoints), while non-susceptibility to piperacillin/tazobactam (according to CLSI breakpoint) or to temocillin (according to Fuchs, Barry, Thornsberry <em>et al. Eur J Clin Microbiol</em> 1985; <strong>4</strong>: 30–3) was highly sensitive (99.8% and 98.2%, respectively) but poorly specific (29.4% and 42.9%, respectively) for the detection of CPE. Temocillin diameters <12 mm alone had high specificity (90.0%) and the combination of temocillin diameters ≥12 mm with piperacillin/tazobactam diameters ≥16 mm observed in 40% of all referred isolates displayed excellent negative predictive value (99.2%).<strong>Conclusions</strong> In geographical areas with a high prevalence of OXA-48 producers, recommended meropenem susceptibility or screening breakpoints failed to detect CPE in a large proportion of isolates. The combination of modified zone diameter cut-offs for piperacillin/tazobactam (≥16 mm) and temocillin (≥12 mm) can be used to rule out the presence of carbapenemase and avoid unnecessary additional testing for confirmation of CPE. application/pdf https://folia.unifr.ch/global/documents/303541 https://folia.unifr.ch/documents/303541/files/dkt367.pdf https://folia.unifr.ch/documents/303541/files/nor_tpt_sm.pdf eng info:eu-repo/semantics/altIdentifier/doi/10.1093/jac/dkt367 info:eu-repo/semantics/openAccess License undefined Journal of Antimicrobial Chemotherapy. - 2014, vol. 69, no. 2, p. 445-450 info:eu-repo/classification/udc/61 Temocillin and piperacillin/tazobactam resistance by disc diffusion as antimicrobial surrogate markers for the detection of carbapenemase-producing Enterobacteriaceae in geographical areas with a high prevalence of OXA-48 producers http://purl.org/coar/resource_type/c_6501