{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:15:25Z","timestamp":1788225325826,"version":"build-2803163510"},"reference-count":40,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100017037","name":"Cepheid","doi-asserted-by":"publisher","award":["Cepheid-IIS-2021-0012"],"award-info":[{"award-number":["Cepheid-IIS-2021-0012"]}],"id":[{"id":"10.13039\/100017037","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Given the current global challenges posed by antimicrobial resistance, the early and accurate identification of carbapenem-resistant Gram-negative bacilli (CR-GNB) is crucial for patient outcomes. This study evaluates the combined diagnostic performance of Xpert Carba-R and Loop-mediated isothermal amplification (LAMP) in the early detection of CR-GNB in patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP) and investigates the effect of early treatment based on detection results on the prognosis of these patients. In this single-center prospective study, 250 HAP\/VAP patients were enrolled. Respiratory specimens underwent bacterial culture, antimicrobial susceptibility testing, Xpert Carba-R, and LAMP. Diagnostic performance (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) of the combined test to detect CR-GNB was assessed. Clinical utility in guiding early antibiotic therapy was evaluated. The combined method demonstrated 64.87% sensitivity (95% CI: 52.89%\u201375.61%) and 94.32% specificity (95% CI: 89.80%\u201397.24%), with perfect 100% sensitivity and specificity for detecting CR-GNB in\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      . Patients testing positive were randomized to early or non-early treatment groups. For severe patients, the early treatment group showed significantly improved clinical outcomes, including lower acute physiology and chronic health evaluation-II (APACHE-II) scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) and sequential organ failure assessment (SOFA) scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) at 15 days post-treatment, along with reduced 30-day hospitalization costs (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Notably, among the critically ill patients, compared with the non-early treatment group, the early treatment group achieved a clinical improvement rate of 81.25% and a microbiological eradication rate of 56.25%, showing a clear advantage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>An urgent clinical need exists for rapid detection of carbapenem-resistant Gram-negative bacilli (CR-GNB) in respiratory specimens to facilitate early and precise antibiotic therapy. To address this gap, we developed an innovative dual-method assay: Xpert Carba-R to detect five major carbapenemases, and loop-mediated isothermal amplification (LAMP) to identify common Gram-negative respiratory pathogens. Integration of these methods enables simultaneous and early determination of bacterial species and their resistance profiles. We validated this assay against conventional culture-based antimicrobial susceptibility testing (AST) and assessed its clinical impact on patient outcomes. Results indicate that this integrated approach provides clinically actionable data, serving as a viable alternative to conventional diagnostic workflows.<\/jats:p>\n                    <jats:p>\n                      This study is registered with the Chinese Clinical Trial Registry as\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/showprojEN.html?proj=239860\" xlink:type=\"simple\">ChiCTR2400090694<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02130-25","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T05:00:32Z","timestamp":1767934832000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Application value of Xpert Carba-R combined with LAMP in the diagnosis and prognosis of carbapenem-resistant Gram-negative bacilli pneumonia"],"prefix":"10.1128","volume":"14","author":[{"given":"Jiannan","family":"Hu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00p991c53","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Ma","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00p991c53","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, 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