Health economics assessment of five methods for detection of carbapenemase-producing <i>Enterobacteriaceae</i>_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Qiaoling , WANG Menghe , LIN Yuling ,  MING Desong

Department of Laboratory Medicine, Affiliated the First Hospital of Quanzhou, Fujian Medical University, Quanzhou, 362000, P.R.China;

Corresponding author：

MING Desong, Email: mds6430@126.com

Keywords：

Carbapenemase-producing Enterobacteriaceae; PCR; Carba NP test; Ultraviolet spectrophotometry; Modified carbapenem inactivation method; Loop-mediated isothermal amplification; Health economics evaluation

DOI：

10.7507/1672-2531.201905081

Video：

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Objective To analyze the cost and performance of five methods for detection of carbapenemase-producing Enterobacteriaceae (CPE), including PCR (method A), Carba NP test (method B), ultraviolet spectrophotometry (method C), modified carbapenem inactivation method (mCIM, method D), and loop-mediated isothermal amplification (LAMP, method E).Methods PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases were searched using the computer regarding literature on detection of CPE with the same or similar designs, same objectives, and independent results. The search was limited between May 2009 and May 2019. Data on the cost and detection performance of all five methods were extracted, and the four special indexes for laboratory tests, such as sensitivity, specificity, simplicity, and rapidity in the utility were quantified as specific values; subsequently, the cost-effective analysis (CEA), cost-utility analysis (CUA), and multi-attribute utility theory (MAUT) in the detection economic analysis were used to conduct health economics evaluation of five detection methods for CPE.Results The cost of methods A, B, C, D and E were 210.00 yuan, 22.00 yuan, 10.50 yuan, 6.00 yuan, and 60.00 yuan, respectively. The C/E of CEA for the above five methods were 210.00, 22.96, 10.66, 6.14, and 60.00, respectively. The C/U of CUA for the above five methods were 302.16, 32.13, 19.30, 11.13, and 80.00, respectively. The MAUT value of the above five methods were 42.56, 5.00, 2.54, 1.63, and 12.56, respectively.Conclusion In terms of CEA, CUA, and MAUT, the method D was the highest in economic value, which usually can be used as a routine method for detecting CPE, but it needs a long procedure time; thus, the method E can be used for rapid detection when clinical severe infection occurred, which is superior in both cost-effectiveness and rapidity.

Citation： YANG Qiaoling, WANG Menghe, LIN Yuling, MING Desong. Health economics assessment of five methods for detection of carbapenemase-producing Enterobacteriaceae. Chinese Journal of Evidence-Based Medicine, 2020, 20(2): 227-233. doi: 10.7507/1672-2531.201905081 Copy

1.	Zhou M, Wang D, Kudinha T, et al. Comparative evaluation of four phenotypic methods for detection of class A and B Carbapenemase-Producing Enterobacteriaceae in China. J Clin Microbiol, 2018, 56(8): 395-318.
2.	Nordmann P, Naas T, Poirel L. Global spread of Carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis, 2011, 17(10): 1791-1798.
3.	明德松. 乙型肝炎病毒表面抗原三种检测方法的检验经济学分析. 厦门: 第三届全国临床检验实验室管理学术会议, 2005.
4.	林梅玉. MAUT 在抗菌药物经济学评价中的应用. 药品评价, 2017, 14(16): 39-41.
5.	Lowman W, Marais M, Ahmed K, et al. Routine active surveillance for carbapenemase-producing Enterobacteriaceae from rectal swabs: diagnostic implications of multiplex polymerase chain reaction. J Hosp Infect, 2014, 88(2): 66-71.
6.	Ong CH, Ratnayake L, Ang MLT, et al. Diagnostic accuracy of BD Phoenix CPO Detect for Carbapenemase Production in 190 Enterobacteriaceae Isolates. J Clin Microbiol, 2018, 56(12): 1043-1018.
7.	Bernabeu S, Poirel L, Nordmann P. Spectrophotometry-based detection of carbapenemase producers among Enterobacteriaceae. Diagn Microbiol Infect Dis, 2012, 74(1): 88-90.
8.	Kuchibiro T, Komatsu M, Yamasaki K, et al. Evaluation of the modified carbapenem inactivation method for the detection of carbapenemase-producing Enterobacteriaceae. J Infect Chemother, 2018, 24(4): 262-266.
9.	Cheng C, Zheng F, Rui Y. Rapid detection of blaNDM, blaKPC, blaIMP, and blaVIM carbapenemase genes in bacteria by loop-mediated isothermal amplification. Microb Drug Resist, 2014, 20(6): 533-538.
10.	马向君. 多属性效用理论对阿卡波糖和二甲双胍单独用药方案药物经济学应用研究. 北京: 北京中医药大学, 2012.
11.	王芳, 孙利华. 多属性效用理论在效果评价中的应用. 中国药事, 2009, 23(7): 637-638, 642.
12.	Tamma PD, Opene BN, Gluck A, et al. Comparison of 11 phenotypic assays for accurate detection of carbapenemase-producing Enterobacteriaceae. J Clin Microbiol, 2017, 55(4): 1046-1055.
13.	Nordmann P, Poirel L, Dortet L. Rapid detection of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis, 2012, 18(9): 1503-1507.
14.	Jousset AB, Bernabeu S, Bonnin RA, et al. Development and validation of a multiplex polymerase chain reaction assay for detection of the five families of plasmid-encoded colistin resistance. Int J Antimicrob Agents, 2019, 53(3): 302-309.
15.	Pierce VM, Simner PJ, Lonsway DR, et al. Modified carbapenem inactivation method for phenotypic detection of Carbapenemase production among Enterobacteriaceae. J Clin Microbiol, 2017, 55(8): 2321-2333.
16.	Liu W, Zou D, Li Y, et al. Sensitive and rapid detection of the new Delhi metallo-beta-lactamase gene by loop-mediated isothermal amplification. J Clin Microbiol, 2012, 50(5): 1580-1585.
17.	Mori Y, Notomi T. Loop-mediated isothermal amplification (LAMP): a rapid, accurate, and cost-effective diagnostic method for infectious diseases. J Infect Chemother, 2009, 15(2): 62-69.
18.	Chavda KD, Chen L, Fouts DE, et al. Comprehensive genome analysis of carbapenemase-producing enterobacter spp.: new insights into phylogeny, population structure, and resistance mechanisms. MBio, 2016, 7(6): 2093-2016.
19.	Potter RF, D'Souza AW, Dantas G. The rapid spread of carbapenem-resistant Enterobacteriaceae. Drug Resist Updat, 2016, 29: 30-46.
20.	Burckhardt I, Zimmermann S. Using matrix-assisted laser desorption ionization-time of flight mass spectrometry to detect carbapenem resistance within 1 to 2.5 hours. J Clin Microbiol, 2011, 49(9): 3321-3324.
21.	Milillo M, Kwak YI, Snesrud E, et al. Correction for Milillo et al., Rapid and simultaneous detection of blaKPC and blaNDM by use of multiplex real-time PCR. J Clin Microbiol, 2015, 53(4): 1460.
22.	Yamada K, Kashiwa M, Arai K, et al. Evaluation of the modified carbapenem inactivation method and sodium mercaptoacetate-combination method for the detection of metallo-β-lactamase production by carbapenemase-producing Enterobacteriaceae. J Microbiol Methods, 2017, 132: 112-115.
23.	Notomi T, Okayama H, Masubuchi H, et al. Loop-mediated isothermal amplification of DNA. Nucleic Acids Res, 2000, 28(12): E63.
24.	Bowers DR, Huang V. Emerging issues and treatment strategies in carbapenem-resistant enterobacteriaceae (CRE). Curr Infect Dis Rep, 2016, 18(12): 48.
25.	Koizumi N, Nakajima C, Harunari T, et al. A new loop-mediated isothermal amplification method for rapid, simple, and sensitive detection of Leptospira spp. in urine. J Clin Microbiol, 2012, 50(6): 2072-2074.
26.	Abdul-Ghani R, Al-Mekhlafi AM, Karanis P. Loop-mediated isothermal amplification (LAMP) for malarial parasites of humans: would it come to clinical reality as a point-of-care test? Acta Trop, 2012, 122(3): 233-240.
27.	Duan YB, Ge CY, Zhang XK, et al. Development and evaluation of a novel and rapid detection assay for Botrytis cinerea based on loop-mediated isothermal amplification. PLoS One, 2014, 9(10): e111094.
28.	Notomi T, Mori Y, Tomita N, et al. Loop-mediated isothermal amplification (LAMP): principle, features, and future prospects. J Microbiol, 2015, 53(1): 1-5.
29.	Tomita N, Mori Y, Kanda H, et al. Loop-mediated isothermal amplification (LAMP) of gene sequences and simple visual detection of products. Nat Protoc, 2008, 3(5): 877-882.
30.	Watts MR, James G, Sultana Y, et al. A loop-mediated isothermal amplification (LAMP) assay for Strongyloides stercoralis in stool that uses a visual detection method with SYTO-82 fluorescent dye. Am J Trop Med Hyg, 2014, 90(2): 306-311.
31.	Karthik K, Rathore R, Thomas P, et al. New closed tube loop mediated isothermal amplification assay for prevention of product cross-contamination. MethodsX, 2014, 1: 137-143.

1. Zhou M, Wang D, Kudinha T, et al. Comparative evaluation of four phenotypic methods for detection of class A and B Carbapenemase-Producing Enterobacteriaceae in China. J Clin Microbiol, 2018, 56(8): 395-318.
2. Nordmann P, Naas T, Poirel L. Global spread of Carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis, 2011, 17(10): 1791-1798.
3. 明德松. 乙型肝炎病毒表面抗原三种检测方法的检验经济学分析. 厦门: 第三届全国临床检验实验室管理学术会议, 2005.
4. 林梅玉. MAUT 在抗菌药物经济学评价中的应用. 药品评价, 2017, 14(16): 39-41.
5. Lowman W, Marais M, Ahmed K, et al. Routine active surveillance for carbapenemase-producing Enterobacteriaceae from rectal swabs: diagnostic implications of multiplex polymerase chain reaction. J Hosp Infect, 2014, 88(2): 66-71.
6. Ong CH, Ratnayake L, Ang MLT, et al. Diagnostic accuracy of BD Phoenix CPO Detect for Carbapenemase Production in 190 Enterobacteriaceae Isolates. J Clin Microbiol, 2018, 56(12): 1043-1018.
7. Bernabeu S, Poirel L, Nordmann P. Spectrophotometry-based detection of carbapenemase producers among Enterobacteriaceae. Diagn Microbiol Infect Dis, 2012, 74(1): 88-90.
8. Kuchibiro T, Komatsu M, Yamasaki K, et al. Evaluation of the modified carbapenem inactivation method for the detection of carbapenemase-producing Enterobacteriaceae. J Infect Chemother, 2018, 24(4): 262-266.
9. Cheng C, Zheng F, Rui Y. Rapid detection of blaNDM, blaKPC, blaIMP, and blaVIM carbapenemase genes in bacteria by loop-mediated isothermal amplification. Microb Drug Resist, 2014, 20(6): 533-538.
10. 马向君. 多属性效用理论对阿卡波糖和二甲双胍单独用药方案药物经济学应用研究. 北京: 北京中医药大学, 2012.
11. 王芳, 孙利华. 多属性效用理论在效果评价中的应用. 中国药事, 2009, 23(7): 637-638, 642.
12. Tamma PD, Opene BN, Gluck A, et al. Comparison of 11 phenotypic assays for accurate detection of carbapenemase-producing Enterobacteriaceae. J Clin Microbiol, 2017, 55(4): 1046-1055.
13. Nordmann P, Poirel L, Dortet L. Rapid detection of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis, 2012, 18(9): 1503-1507.
14. Jousset AB, Bernabeu S, Bonnin RA, et al. Development and validation of a multiplex polymerase chain reaction assay for detection of the five families of plasmid-encoded colistin resistance. Int J Antimicrob Agents, 2019, 53(3): 302-309.
15. Pierce VM, Simner PJ, Lonsway DR, et al. Modified carbapenem inactivation method for phenotypic detection of Carbapenemase production among Enterobacteriaceae. J Clin Microbiol, 2017, 55(8): 2321-2333.
16. Liu W, Zou D, Li Y, et al. Sensitive and rapid detection of the new Delhi metallo-beta-lactamase gene by loop-mediated isothermal amplification. J Clin Microbiol, 2012, 50(5): 1580-1585.
17. Mori Y, Notomi T. Loop-mediated isothermal amplification (LAMP): a rapid, accurate, and cost-effective diagnostic method for infectious diseases. J Infect Chemother, 2009, 15(2): 62-69.
18. Chavda KD, Chen L, Fouts DE, et al. Comprehensive genome analysis of carbapenemase-producing enterobacter spp.: new insights into phylogeny, population structure, and resistance mechanisms. MBio, 2016, 7(6): 2093-2016.
19. Potter RF, D'Souza AW, Dantas G. The rapid spread of carbapenem-resistant Enterobacteriaceae. Drug Resist Updat, 2016, 29: 30-46.
20. Burckhardt I, Zimmermann S. Using matrix-assisted laser desorption ionization-time of flight mass spectrometry to detect carbapenem resistance within 1 to 2.5 hours. J Clin Microbiol, 2011, 49(9): 3321-3324.
21. Milillo M, Kwak YI, Snesrud E, et al. Correction for Milillo et al., Rapid and simultaneous detection of blaKPC and blaNDM by use of multiplex real-time PCR. J Clin Microbiol, 2015, 53(4): 1460.
22. Yamada K, Kashiwa M, Arai K, et al. Evaluation of the modified carbapenem inactivation method and sodium mercaptoacetate-combination method for the detection of metallo-β-lactamase production by carbapenemase-producing Enterobacteriaceae. J Microbiol Methods, 2017, 132: 112-115.
23. Notomi T, Okayama H, Masubuchi H, et al. Loop-mediated isothermal amplification of DNA. Nucleic Acids Res, 2000, 28(12): E63.
24. Bowers DR, Huang V. Emerging issues and treatment strategies in carbapenem-resistant enterobacteriaceae (CRE). Curr Infect Dis Rep, 2016, 18(12): 48.
25. Koizumi N, Nakajima C, Harunari T, et al. A new loop-mediated isothermal amplification method for rapid, simple, and sensitive detection of Leptospira spp. in urine. J Clin Microbiol, 2012, 50(6): 2072-2074.
26. Abdul-Ghani R, Al-Mekhlafi AM, Karanis P. Loop-mediated isothermal amplification (LAMP) for malarial parasites of humans: would it come to clinical reality as a point-of-care test? Acta Trop, 2012, 122(3): 233-240.
27. Duan YB, Ge CY, Zhang XK, et al. Development and evaluation of a novel and rapid detection assay for Botrytis cinerea based on loop-mediated isothermal amplification. PLoS One, 2014, 9(10): e111094.
28. Notomi T, Mori Y, Tomita N, et al. Loop-mediated isothermal amplification (LAMP): principle, features, and future prospects. J Microbiol, 2015, 53(1): 1-5.
29. Tomita N, Mori Y, Kanda H, et al. Loop-mediated isothermal amplification (LAMP) of gene sequences and simple visual detection of products. Nat Protoc, 2008, 3(5): 877-882.
30. Watts MR, James G, Sultana Y, et al. A loop-mediated isothermal amplification (LAMP) assay for Strongyloides stercoralis in stool that uses a visual detection method with SYTO-82 fluorescent dye. Am J Trop Med Hyg, 2014, 90(2): 306-311.
31. Karthik K, Rathore R, Thomas P, et al. New closed tube loop mediated isothermal amplification assay for prevention of product cross-contamination. MethodsX, 2014, 1: 137-143.

Chinese Journal of Evidence-Based Medicine

Health economics assessment of five methods for detection of carbapenemase-producing Enterobacteriaceae

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