{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:07:27Z","timestamp":1770289647746,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundaci\u00f3n Cl\u00ednica Shaio"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Early and adequate antibiotic treatment is the cornerstone of improving clinical outcomes in patients with bloodstream infections (BSI). Delays in appropriate antimicrobial therapy have catastrophic consequences for patients with BSI. Microbiological characterization of multi-drug resistant pathogens (MDRP) allows clinicians to provide appropriate treatments. Current microbiologic techniques may take up to 96 h to identify causative pathogens and their resistant patterns. Therefore, there is an important need to develop rapid diagnostic strategies for MDRP. We tested a modified protocol to detect carbapenemase and extended-spectrum \u03b2-lactamase (ESBL) producing Gram-negative bacteria (GNB) from positive blood cultures. Methods: This is a prospective cohort study of consecutive patients with bacteremia. We developed a modified protocol using the HB&amp;L\u00ae system to detect MDRP. The operational characteristics were analyzed for each test (HB&amp;L-ESBL\/AmpC\u00ae and HB&amp;L-Carbapenemase\u00ae kits). The kappa coefficient, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratios (LR) with 95% confidence intervals (CI), and reduction in identification time of this novel method were calculated. Results: Ninety-six patients with BSI were included in the study. A total of 161 positive blood cultures were analyzed. Escherichia coli (50%, 81\/161) was the most frequently identified pathogen, followed by Klebsiella pneumoniae (15%, 24\/161) and Pseudomonas aeruginosa (8%, 13\/161). Thirty-three percent of isolations had usual resistance patterns. However, 34\/161 (21%) of identified pathogens were producers of carbapenemases and 21\/161 (13%) of extended-spectrum \u03b2-lactamases. Concordance between our HB&amp;L\u00ae modified protocol and the traditional method was 99% (159\/161). Finally, identification times were significantly shorter using our HB&amp;L\u00ae-modified protocol than traditional methods: median (IQR) 19 h (18, 22) vs. 61 h (60, 64), p &lt; 0.001. Conclusions: Here, we provide novel evidence that using our HB&amp;L\u00ae-modified protocol is an effective strategy to reduce the time to detect MDRP producers of carbapenemases or extended-spectrum \u03b2-lactamases, with an excellent concordance rate when compared to the gold standard. Further studies are needed to confirm these findings and to determine whether this method may improve clinical outcomes.<\/jats:p>","DOI":"10.3390\/antibiotics12010034","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T04:40:39Z","timestamp":1672116039000},"page":"34","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rapid Detection of Carbapenemase and Extended-Spectrum \u03b2-Lactamase Producing Gram-Negative Bacteria Directly from Positive Blood Cultures Using a Novel Protocol"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0870-7257","authenticated-orcid":false,"given":"Diego","family":"Josa","sequence":"first","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid","family":"Bustos","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soad","family":"Yusef","sequence":"additional","affiliation":[{"name":"Department of Critical Medicine, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110111, Colombia"},{"name":"Unisabana Center of Translational Science, Universidad de la Sabana, Ch\u00eda 53753, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7892-7066","authenticated-orcid":false,"given":"Stephanie","family":"Crevoisier","sequence":"additional","affiliation":[{"name":"Department of Critical Medicine, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110111, Colombia"},{"name":"Unisabana Center of Translational Science, Universidad de la Sabana, Ch\u00eda 53753, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8117-0957","authenticated-orcid":false,"given":"Edwin","family":"Silva","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"},{"name":"Infectious Diseases Department, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110111, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Leal","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Molina","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Osorio","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"},{"name":"Infectious Diseases Department, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110111, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerson","family":"Arias","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"},{"name":"Infectious Diseases Department, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110111, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabi\u00e1n","family":"Cort\u00e9s-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Medicine and Specialties of High Complexity, Fundaci\u00f3n Cl\u00ednica Shaio, Bogot\u00e1 110121, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1172-6539","authenticated-orcid":false,"given":"Luis","family":"Reyes","sequence":"additional","affiliation":[{"name":"Unisabana Center of Translational Science, Universidad de la Sabana, Ch\u00eda 53753, Colombia"},{"name":"Department of Critical Care, Cl\u00ednica Universidad de La Sabana, Ch\u00eda 250001, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/S1473-3099(13)70318-9","article-title":"Antibiotic resistance-the need for global solutions","volume":"13","author":"Laxminarayan","year":"2013","journal-title":"Lancet Infect. 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